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Background <p>Clinical trials have shown the efficacy of adding CDK4/6 inhibitors to standard endocrine therapy in hormone receptor (HR)-positive, human epidermal growth factor receptor II (HER2)-negative high-risk early breast cancer.</p> Materials and methods <p>HR+ /HER2− early breast cancers were retrieved from cancer registry. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) among trial-defined high-risk patients, as well as the impact of adjuvant chemotherapy.</p> Results <p>Among 2758 registered cases, 511 and 1207 patients met MonarchE (M) and NATALEE (N) high-risk criteria, respectively. OS was 94.8% for M-high/N-high, 96.8% for M-low/N-high, 90.7% for M-high/N-low, and 98.9% for M-low/N-low patients, with a hazard ratio (HR) of 2.3 and 2.8 for M-high and N-high, respectively. For RFS, chemotherapy reduced recurrence risk in M-high patients (HR: 0.24) but showed no benefit for N-high patients overall, except for stage III N-high cases (HR: 0.2).</p> Conclusion <p>Adjuvant chemotherapy significantly reduced recurrence risk in M-high patients with early breast cancer. Further stratification of M-low/N-high patients is needed to guide tailored chemotherapy approaches alongside CDK4/6 inhibition.</p>

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Survival outcomes in trial defined high-risk hormone receptor-positive/human epidermal growth factor receptor II-negative early breast cancer: impact of adjuvant chemotherapy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月16日

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  • Ta-Chung Chao,
  • Deanna Gracia,
  • Chan-Heng Ho,
  • Hao-Yang Chen,
  • Chi-Cheng Huang,
  • Ling-Ming Tseng

摘要

Background

Clinical trials have shown the efficacy of adding CDK4/6 inhibitors to standard endocrine therapy in hormone receptor (HR)-positive, human epidermal growth factor receptor II (HER2)-negative high-risk early breast cancer.

Materials and methods

HR+ /HER2− early breast cancers were retrieved from cancer registry. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS) among trial-defined high-risk patients, as well as the impact of adjuvant chemotherapy.

Results

Among 2758 registered cases, 511 and 1207 patients met MonarchE (M) and NATALEE (N) high-risk criteria, respectively. OS was 94.8% for M-high/N-high, 96.8% for M-low/N-high, 90.7% for M-high/N-low, and 98.9% for M-low/N-low patients, with a hazard ratio (HR) of 2.3 and 2.8 for M-high and N-high, respectively. For RFS, chemotherapy reduced recurrence risk in M-high patients (HR: 0.24) but showed no benefit for N-high patients overall, except for stage III N-high cases (HR: 0.2).

Conclusion

Adjuvant chemotherapy significantly reduced recurrence risk in M-high patients with early breast cancer. Further stratification of M-low/N-high patients is needed to guide tailored chemotherapy approaches alongside CDK4/6 inhibition.