Abstract
Purpose
In the adjuvant setting, specific adverse events (AEs) such as vasomotor symptoms
(VMS) and musculoskeletal AEs are associated with relapse-free survival in aromatase
inhibitor (AI)-treated patients. In the neoadjuvant setting, specific AEs may be associated
with tumor response to AIs as well.
Methods
Between 2007 and 2012, 107 patients participated in the prospective TEAMIIA trial,
a prospective, phase II trial investigating 6 months of neoadjuvant exemestane in
patients with strongly ER-positive breast cancer. Radiological response (≥30% decrease
in tumor size) was studied in relation to VMSs and MSAEs. Pearson's Chi-Square tests
and multivariate logistic regression analyses were used to evaluate of statistical
significance (p < 0.05).
Results
Out of 102 patients 26 patients (25.4%) experienced at least one episode of VMS and
27 patients (26.4%) experienced MSAE. Out of 240 reported adverse events, 71 were
specific AEs (40 MSAEs, 31 VMSs). Radiological response was greater in patients who
reported VMSs compared to patients who did not (70.8% vs. 49.3%, multivariate OR 2.91,
95% C.I. 1.03–8.26, P = 0.045). No significant advantage towards better response was
observed in patients who experienced MSAEs (60.0% vs. 53.3%, univariate OR 1.33, 95%
C.I. 0.53–3.38, P = 0.545).
Conclusion
VMSs are associated with tumor response to neoadjuvant exemestane and may be useful
for predicting treatment outcomes of AI treatment at an early stage in patients treated
with neoadjuvant AIs.
Keywords
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Article info
Publication history
Published online: December 12, 2016
Accepted:
July 4,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
