Adding Ovarian Suppression to Tamoxifen for Premenopausal Women With Hormone Receptor-Positive Breast Cancer After Chemotherapy: An 8-Year Follow-Up of the ASTRRA Trial
- Abstract
- Purpose: To determine the updated long-term outcomes of the Addition of Ovarian Suppression to Tamoxifen in Young Women With Hormone-Sensitive Breast Cancer Who Remain Premenopausal or Regain Vaginal Bleeding After Chemotherapy (ASTRRA) trial.
Patients and methods: This study is a post-trial follow-up of the ASTRRA trial, involving 1,483 premenopausal women younger than 45 years treated with definitive surgery after completing adjuvant or neoadjuvant chemotherapy for estrogen receptor-positive breast cancer. Patients were randomly assigned in a 1:1 ratio to complete 5 years of tamoxifen (TAM) alone (TAM-only) or 5 years of TAM with ovarian function suppression (OFS) for 2 years (TAM + OFS). The primary end point was disease-free survival (DFS), and the secondary end point was overall survival (OS).
Results: At 106.4 months of median follow-up, there was a continuous significant reduction in the DFS event rate in the TAM + OFS group. The 8-year DFS rate was 85.4% in the TAM + OFS group and 80.2% in the TAM-only group (hazard ratio [HR], 0.67; 95% CI, 0.51 to 0.87). There were no significant differences in OS between the two groups. The OS rate was 96.5% in the TAM + OFS group and 95.3% in the TAM-only group (HR, 0.78; 95% CI, 0.49 to 1.25).
Conclusion: Adding OFS for 2 years to adjuvant TAM with a longer follow-up resulted in consistent DFS benefits, suggesting that adding OFS to TAM should be considered for patients who remain in a premenopausal state or resume ovarian function after chemotherapy.
- All Author(s)
- Soo Yeon Baek
; Woo Chul Noh
; Sei-Hyun Ahn
; Hyun-Ah Kim
; Jai Min Ryu
; Seung Il Kim
; Eun-Gyeong Lee
; Seock-Ah Im
; Yongsik Jung
; Min Ho Park
; Kyong Hwa Park
; Su Hwan Kang
; Joon Jeong
; Eunhwa Park
; Sung Yong Kim
; Min Hyuk Lee
; Lee Su Kim
; Woosung Lim
; Seonok Kim
; Hee Jeong Kim
- Issued Date
- 2023
- Type
- Article
- Publisher
- American Society of Clinical Oncology
- ISSN
- 0732-183x
; 1527-7755
- Citation Title
- Journal of clinical oncology
- Citation Volume
- 41
- Citation Number
- 31
- Citation Start Page
- 4864
- Citation End Page
- 4871
- Language(ISO)
- eng
- DOI
- 10.1200/JCO.23.00557
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/3331
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