Journal Article
. 2018 Jun;379(2).
doi: 10.1056/NEJMoa1803164.

Tailoring Adjuvant Endocrine Therapy for Premenopausal Breast Cancer

Prudence A Francis 1 Olivia Pagani 1 Gini F Fleming 1 Barbara A Walley 1 Marco Colleoni 1 István Láng 1 Henry L Gómez 1 Carlo Tondini 1 Eva Ciruelos 1 Harold J Burstein 1 Hervé R Bonnefoi 1 Meritxell Bellet 1 Silvana Martino 1 Charles E Geyer 1 Matthew P Goetz 1 Vered Stearns 1 Graziella Pinotti 1 Fabio Puglisi 1 Simon Spazzapan 1 Miguel A Climent 1 Lorenzo Pavesi 1 Thomas Ruhstaller 1 Nancy E Davidson 1 Robert Coleman 1 Marc Debled 1 Stefan Buchholz 1 James N Ingle 1 Eric P Winer 1 Rudolf Maibach 1 Manuela Rabaglio-Poretti 1 Barbara Ruepp 1 Angelo Di Leo 1 Alan S Coates 1 Richard D Gelber 1 Aron Goldhirsch 1 Meredith M Regan 1 SOFT and TEXT Investigators and the International Breast Cancer Study Group  
  • PMID: 29863451
  •     25 References
  •     48 citations


Background: In the Suppression of Ovarian Function Trial (SOFT) and the Tamoxifen and Exemestane Trial (TEXT), the 5-year rates of recurrence of breast cancer were significantly lower among premenopausal women who received the aromatase inhibitor exemestane plus ovarian suppression than among those who received tamoxifen plus ovarian suppression. The addition of ovarian suppression to tamoxifen did not result in significantly lower recurrence rates than those with tamoxifen alone. Here, we report the updated results from the two trials.

Methods: Premenopausal women were randomly assigned to receive 5 years of tamoxifen, tamoxifen plus ovarian suppression, or exemestane plus ovarian suppression in SOFT and to receive tamoxifen plus ovarian suppression or exemestane plus ovarian suppression in TEXT. Randomization was stratified according to the receipt of chemotherapy.

Results: In SOFT, the 8-year disease-free survival rate was 78.9% with tamoxifen alone, 83.2% with tamoxifen plus ovarian suppression, and 85.9% with exemestane plus ovarian suppression (P=0.009 for tamoxifen alone vs. tamoxifen plus ovarian suppression). The 8-year rate of overall survival was 91.5% with tamoxifen alone, 93.3% with tamoxifen plus ovarian suppression, and 92.1% with exemestane plus ovarian suppression (P=0.01 for tamoxifen alone vs. tamoxifen plus ovarian suppression); among the women who remained premenopausal after chemotherapy, the rates were 85.1%, 89.4%, and 87.2%, respectively. Among the women with cancers that were negative for HER2 who received chemotherapy, the 8-year rate of distant recurrence with exemestane plus ovarian suppression was lower than the rate with tamoxifen plus ovarian suppression (by 7.0 percentage points in SOFT and by 5.0 percentage points in TEXT). Grade 3 or higher adverse events were reported in 24.6% of the tamoxifen-alone group, 31.0% of the tamoxifen-ovarian suppression group, and 32.3% of the exemestane-ovarian suppression group.

Conclusions: Among premenopausal women with breast cancer, the addition of ovarian suppression to tamoxifen resulted in significantly higher 8-year rates of both disease-free and overall survival than tamoxifen alone. The use of exemestane plus ovarian suppression resulted in even higher rates of freedom from recurrence. The frequency of adverse events was higher in the two groups that received ovarian suppression than in the tamoxifen-alone group. (Funded by Pfizer and others; SOFT and TEXT numbers, NCT00066690 and NCT00066703 , respectively.).

ESO-ESMO 3rd international consensus guidelines for breast cancer in young women (BCY3).
Shani Paluch-Shimon, Olivia Pagani, +15 authors, Fatima Cardoso.
Breast, 2017 Aug 20; 35. PMID: 28822332
Highly Cited.
Patient-reported outcomes with adjuvant exemestane versus tamoxifen in premenopausal women with early breast cancer undergoing ovarian suppression (TEXT and SOFT): a combined analysis of two phase 3 randomised trials.
Jürg Bernhard, Weixiu Luo, +18 authors, Barbara A Walley.
Lancet Oncol, 2015 Jun 21; 16(7). PMID: 26092816    Free PMC article.
Tailoring therapies--improving the management of early breast cancer: St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2015.
A S Coates, E P Winer, +6 authors, Panel Members.
Ann Oncol, 2015 May 06; 26(8). PMID: 25939896    Free PMC article.
Highly Cited.
Is chemotherapy alone adequate for young women with oestrogen-receptor-positive breast cancer?
S Aebi, S Gelber, +11 authors, A Goldhirsch.
Lancet, 2000 Jun 24; 355(9218). PMID: 10866443
Adjuvant exemestane with ovarian suppression in premenopausal breast cancer.
Olivia Pagani, Meredith M Regan, +32 authors, International Breast Cancer Study Group.
N Engl J Med, 2014 Jun 03; 371(2). PMID: 24881463    Free PMC article.
Highly Cited.
HER2 status predicts for upfront AI benefit: A TRANS-AIOG meta-analysis of 12,129 patients from ATAC, BIG 1-98 and TEAM with centrally determined HER2.
John M S Bartlett, Ikhlaaq Ahmed, +14 authors, Translational Aromatase Inhibitor Overview Group (Trans-AIOG).
Eur J Cancer, 2017 May 12; 79. PMID: 28494403
Absolute Benefit of Adjuvant Endocrine Therapies for Premenopausal Women With Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Early Breast Cancer: TEXT and SOFT Trials.
Meredith M Regan, Prudence A Francis, +12 authors, Richard D Gelber.
J Clin Oncol, 2016 Apr 06; 34(19). PMID: 27044936    Free PMC article.
Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG), C Davies, +11 authors, R Peto.
Lancet, 2011 Aug 02; 378(9793). PMID: 21802721    Free PMC article.
Highly Cited.
Survival patterns after oophorectomy in premenopausal women: a population-based cohort study.
Walter A Rocca, Brandon R Grossardt, +2 authors, L Joseph Melton.
Lancet Oncol, 2006 Oct 03; 7(10). PMID: 17012044
Highly Cited.
Tamoxifen after adjuvant chemotherapy for premenopausal women with lymph node-positive breast cancer: International Breast Cancer Study Group Trial 13-93.
International Breast Cancer Study Group, Marco Colleoni, +6 authors, Richard D Gelber.
J Clin Oncol, 2006 Mar 01; 24(9). PMID: 16505417
Incidence-based cost-of-illness model for metastatic breast cancer in the United States.
Sonja V Sorensen, Jo Wern Goh, +7 authors, Shrividya Iyer.
Int J Technol Assess Health Care, 2012 May 24; 28(1). PMID: 22617734
Adjuvant Tamoxifen Plus Ovarian Function Suppression Versus Tamoxifen Alone in Premenopausal Women With Early Breast Cancer: Patient-Reported Outcomes in the Suppression of Ovarian Function Trial.
Karin Ribi, Weixiu Luo, +24 authors, Gini F Fleming.
J Clin Oncol, 2016 Mar 30; 34(14). PMID: 27022111    Free PMC article.
Adjuvant Endocrine Therapy for Women With Hormone Receptor-Positive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Update on Ovarian Suppression.
Harold J Burstein, Christina Lacchetti, +9 authors, Jennifer J Griggs.
J Clin Oncol, 2016 Feb 18; 34(14). PMID: 26884586
Highly Cited. Systematic Review.
Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses' health study.
William H Parker, Diane Feskanich, +5 authors, Joann E Manson.
Obstet Gynecol, 2013 May 03; 121(4). PMID: 23635669    Free PMC article.
Highly Cited.
Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.
Christina Davies, Hongchao Pan, +36 authors, Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group.
Lancet, 2012 Dec 12; 381(9869). PMID: 23219286    Free PMC article.
Highly Cited.
Adjuvant therapy for very young women with breast cancer: need for tailored treatments.
A Goldhirsch, R D Gelber, +6 authors, A S Coates.
J Natl Cancer Inst Monogr, 2002 Jan 05; (30). PMID: 11773291
Accelerated Accumulation of Multimorbidity After Bilateral Oophorectomy: A Population-Based Cohort Study.
Walter A Rocca, Liliana Gazzuola-Rocca, +6 authors, Virginia M Miller.
Mayo Clin Proc, 2016 Oct 04; 91(11). PMID: 27693001    Free PMC article.
Highly Cited.
Adjuvant treatment of premenopausal women with endocrine-responsive early breast cancer: design of the TEXT and SOFT trials.
Meredith M Regan, Olivia Pagani, +12 authors, GroupSOFT and TEXT Investigators.
Breast, 2013 Oct 08; 22(6). PMID: 24095609    Free PMC article.
Adjuvant ovarian suppression in premenopausal breast cancer.
Prudence A Francis, Meredith M Regan, +28 authors, International Breast Cancer Study Group.
N Engl J Med, 2014 Dec 17; 372(5). PMID: 25495490    Free PMC article.
Highly Cited.
Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease.
M Colleoni, N Rotmensz, +12 authors, A Goldhirsch.
Ann Oncol, 2006 Jun 27; 17(10). PMID: 16798834
Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12.
M Gnant, B Mlineritsch, +23 authors, Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria.
Ann Oncol, 2014 Nov 19; 26(2). PMID: 25403582
Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.
Early Breast Cancer Trialists' Collaborative Group (EBCTCG).
Lancet, 2015 Jul 28; 386(10001). PMID: 26211827
Highly Cited.
20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years.
Hongchao Pan, Richard Gray, +9 authors, EBCTCG.
N Engl J Med, 2017 Nov 09; 377(19). PMID: 29117498    Free PMC article.
Highly Cited.
Use of luteinising-hormone-releasing hormone agonists as adjuvant treatment in premenopausal patients with hormone-receptor-positive breast cancer: a meta-analysis of individual patient data from randomised adjuvant trials.
LHRH-agonists in Early Breast Cancer Overview group, J Cuzick, +5 authors, R Sainsbury.
Lancet, 2007 May 22; 369(9574). PMID: 17512856
Treatment Efficacy, Adherence, and Quality of Life Among Women Younger Than 35 Years in the International Breast Cancer Study Group TEXT and SOFT Adjuvant Endocrine Therapy Trials.
Poornima Saha, Meredith M Regan, +25 authors, International Breast Cancer Study Group.
J Clin Oncol, 2017 Jun 28; 35(27). PMID: 28654365    Free PMC article.
An Italian Delphi study to evaluate consensus on adjuvant endocrine therapy in premenopausal patients with breast cancer: the ERA project.
Giacomo Pelizzari, Grazia Arpino, +8 authors, Fabio Puglisi.
BMC Cancer, 2018 Sep 29; 18(1). PMID: 30261866    Free PMC article.
Funds Reimbursement of High-Cost Drugs in Gastrointestinal Oncology: An Italian Real Practice 1 Year Experience at the National Cancer Institute of Naples.
Monica Capozzi, Chiara De Divitiis, +7 authors, Abdominal Oncology Group.
Front Public Health, 2018 Oct 30; 6. PMID: 30370266    Free PMC article.
Update Breast Cancer 2018 (Part 3) - Genomics, Individualized Medicine and Immune Therapies - in the Middle of a New Era: Prevention and Treatment Strategies for Early Breast Cancer.
Achim Wöckel, Michael P Lux, +17 authors, Hans-Christian Kolberg.
Geburtshilfe Frauenheilkd, 2018 Dec 01; 78(11). PMID: 30498278    Free PMC article.
Adjuvant Systemic Treatment of Premenopausal Women With Hormone Receptor-Positive Early Breast Cancer: Lights and Shadows.
Meredith M Regan, Gini F Fleming, +2 authors, Olivia Pagani.
J Clin Oncol, 2019 Feb 28; 37(11). PMID: 30811287    Free PMC article.
Exemestane Plus Ovarian Function Suppression Is the Best Adjuvant Treatment of Premenopausal Women With Endocrine-Responsive Breast Cancer at Higher Risk of Relapse and With HER2-Negative Tumors.
Fabio Conforti, Laura Pala.
J Clin Oncol, 2019 Jun 08; 37(21). PMID: 31173554    Free PMC article.
Survival outcome of combined GnRH agonist and tamoxifen is comparable to that of sequential adriamycin and cyclophosphamide chemotherapy plus tamoxifen in premenopausal patients with early breast cancer.
Doonyapat Sa-Nguanraksa, Thitikon Krisorakun, Wanee Pongthong, Pornchai O-Charoenrat.
Mol Clin Oncol, 2019 Oct 18; 11(5). PMID: 31620283    Free PMC article.
Exercise therapies for preventing or treating aromatase inhibitor-induced musculoskeletal symptoms in early breast cancer.
Kate E Roberts, Kirsty Rickett, +2 authors, Natasha E Woodward.
Cochrane Database Syst Rev, 2020 Jan 30; 1. PMID: 31994181    Free PMC article.
Systematic Review.
MiR-1285-5p/TMEM194A axis affects cell proliferation in breast cancer.
Ai Hironaka-Mitsuhashi, Kurataka Otsuka, +5 authors, Takahiro Ochiya.
Cancer Sci, 2019 Dec 20; 111(2). PMID: 31854049    Free PMC article.
Clinical and Genomic Risk to Guide the Use of Adjuvant Therapy for Breast Cancer.
Joseph A Sparano, Robert J Gray, +27 authors, George W Sledge.
N Engl J Med, 2019 Jun 04; 380(25). PMID: 31157962    Free PMC article.
Highly Cited.
Gonadotropin-Releasing Hormone (GnRH) Agonists for Fertility Preservation: Is POEMS the Final Verse?
Bo Yu, Nancy E Davidson.
J Natl Cancer Inst, 2018 Oct 30; 111(2). PMID: 30371813    Free PMC article.
Prognostic Impact of the 21-Gene Recurrence Score Assay Among Young Women With Node-Negative and Node-Positive ER-Positive/HER2-Negative Breast Cancer.
Philip D Poorvu, Shari I Gelber, +12 authors, Ann H Partridge.
J Clin Oncol, 2019 Dec 07; 38(7). PMID: 31809240    Free PMC article.
Incidence and Survival Among Young Women With Stage I-III Breast Cancer: SEER 2000-2015.
Alexandra Thomas, Anthony Rhoads, +7 authors, Paul A Romitti.
JNCI Cancer Spectr, 2019 Aug 09; 3(3). PMID: 31392297    Free PMC article.
Efficacy of anastrozole after tamoxifen in early breast cancer patients with chemotherapy-induced ovarian function failure.
Irene E G van Hellemond, Ingeborg J H Vriens, +15 authors, Dutch Breast Cancer Research Group (BOOG).
Int J Cancer, 2018 Dec 28; 145(1). PMID: 30588619    Free PMC article.
Avoiding over- and undertreatment in patients with resected node-positive breast cancer with the use of gene expression signatures: are we there yet?
A Matikas, T Foukakis, S Swain, J Bergh.
Ann Oncol, 2019 May 28; 30(7). PMID: 31131397    Free PMC article.
Potent inhibition of breast cancer by bis-indole-derived nuclear receptor 4A1 (NR4A1) antagonists.
Erik Hedrick, Xi Li, +4 authors, Stephen Safe.
Breast Cancer Res Treat, 2019 May 24; 177(1). PMID: 31119568    Free PMC article.
Effects of Age and Immune Landscape on Outcome in HER2-Positive Breast Cancer in the NCCTG N9831 (Alliance) and NSABP B-31 (NRG) Trials.
Saranya Chumsri, Daniel J Serie, +10 authors, E Aubrey Thompson.
Clin Cancer Res, 2019 Feb 28; 25(14). PMID: 30808774    Free PMC article.
Prognostic study for isolated local recurrence operated with salvage excision in hormone-receptor-positive patients with invasive breast cancer after primary breast surgery.
Chi-Chang Yu, Wen-Lin Kuo, +4 authors, Shin-Cheh Chen.
Biomed J, 2020 Mar 24; 43(1). PMID: 32200960    Free PMC article.
Ovarian suppression for adjuvant treatment of hormone receptor-positive early breast cancer.
Kim Tam Bui, Melina L Willson, +2 authors, Annabel Goodwin.
Cochrane Database Syst Rev, 2020 Mar 07; 3. PMID: 32141074    Free PMC article.
Systematic Review.
Absolute Improvements in Freedom From Distant Recurrence to Tailor Adjuvant Endocrine Therapies for Premenopausal Women: Results From TEXT and SOFT.
Olivia Pagani, Prudence A Francis, +13 authors, SOFT and TEXT Investigators and International Breast Cancer Study Group.
J Clin Oncol, 2019 Oct 17; 38(12). PMID: 31618131    Free PMC article.
Issues with Fertility in Young Women with Breast Cancer.
Nicole Christian, Mary L Gemignani.
Curr Oncol Rep, 2019 May 18; 21(7). PMID: 31098718
Preventing Breast Cancer in High-Risk Women: Is There Still a Role for Oophorectomy?
Barbara M Norquist, Elizabeth M Swisher, Rachel L Yung.
JNCI Cancer Spectr, 2020 Apr 28; 4(1). PMID: 32337493    Free PMC article.
Young Women with Breast Cancer: Fertility Preservation Options and Management of Pregnancy-Associated Breast Cancer.
Nikita M Shah, Dana M Scott, +4 authors, Jacqueline S Jeruss.
Ann Surg Oncol, 2019 Jan 27; 26(5). PMID: 30680478    Free PMC article.
Tumor Necrosis Factor α Blockade: An Opportunity to Tackle Breast Cancer.
María Florencia Mercogliano, Sofía Bruni, Patricia V Elizalde, Roxana Schillaci.
Front Oncol, 2020 May 12; 10. PMID: 32391269    Free PMC article.
Current State of the Art in the Adjuvant Systemic Treatment of Premenopausal Patients With Early Breast Cancer.
Francesca Parisi, Maria Grazia Razeti, +7 authors, Matteo Lambertini.
Clin Med Insights Oncol, 2020 Jul 11; 14. PMID: 32647477    Free PMC article.
Management of hormone receptor-positive, HER2-negative early breast cancer.
Elaine M Walsh, Karen L Smith, Vered Stearns.
Semin Oncol, 2020 Jun 18; 47(4). PMID: 32546323    Free PMC article.
Late effects of adjuvant chemotherapy adumbrate dormancy complexity in breast cancer.
Romano Demicheli, Christine Desmedt, +3 authors, Elia Biganzoli.
Breast, 2020 May 20; 52. PMID: 32428688    Free PMC article.
Estimation of historical control rate for a single arm de-escalation study - Application to the POSITIVE trial.
Zhuoxin Sun, Samuel M Niman, +9 authors, POSITIVE Steering Committee.
Breast, 2020 Jun 15; 53. PMID: 32535486    Free PMC article.
Incidence and Survival by Human Epidermal Growth Factor Receptor 2 Status in Young Women With Stage I-III Breast Cancer: SEER, 2010-2016.
Alexandra Thomas, Anthony Rhoads, +7 authors, Paul A Romitti.
Clin Breast Cancer, 2020 Apr 13; 20(4). PMID: 32278642    Free PMC article.
The healthcare value of the Magee Decision Algorithm™: use of Magee Equations™ and mitosis score to safely forgo molecular testing in breast cancer.
Rohit Bhargava, Beth Z Clark, +2 authors, David J Dabbs.
Mod Pathol, 2020 Mar 24; 33(8). PMID: 32203092    Free PMC article.
Application of the ESMO-Magnitude of Clinical Benefit Scale (V.1.1) to the field of early breast cancer therapies.
Shani Paluch-Shimon, Nathan I Cherny, +4 authors, Fatima Cardoso.
ESMO Open, 2020 Sep 08; 5(5). PMID: 32893189    Free PMC article.
More is not always better-what can be learned from the D-CARE trial.
Georg Pfeiler, Michael Gnant.
Ann Transl Med, 2020 Sep 22; 8(16). PMID: 32953834    Free PMC article.
Therapeutic advances in hormone-dependent cancers: focus on prostate, breast and ovarian cancers.
Michael Ulm, Arvind V Ramesh, +3 authors, Ramesh Narayanan.
Endocr Connect, 2019 Jan 15; 8(2). PMID: 30640710    Free PMC article.
Switching to anastrozole plus goserelin vs continued tamoxifen for adjuvant therapy of premenopausal early-stage breast cancer: preliminary results from a randomized trial.
Jian-Wei Li, Guang-Yu Liu, +7 authors, Zhi-Ming Shao.
Cancer Manag Res, 2019 Jan 16; 11. PMID: 30643455    Free PMC article.
Locally advanced breast cancer in Brazil: current status and future perspectives.
Gustavo Werutsky, Paulo Nunes, Carlos Barrios.
Ecancermedicalscience, 2019 Feb 23; 13. PMID: 30792812    Free PMC article.
Ovarian Function and Fertility Preservation in Breast Cancer: Should Gonadotropin-Releasing Hormone Agonist be administered to All Premenopausal Patients Receiving Chemotherapy?
Matteo Lambertini, François Richard, +2 authors, Cynthia Villarreal-Garza.
Clin Med Insights Reprod Health, 2019 Mar 20; 13. PMID: 30886529    Free PMC article.
pS6K1 as an efficacy marker of GnRH agonist with premenopausal breast cancer.
Chan Sub Park, Jihye Choi, +6 authors, Hyun-Ah Kim.
Endocr Connect, 2019 Jun 30; 8(7). PMID: 31252399    Free PMC article.
Cardiometabolic Effects of Endocrine Treatment of Estrogen Receptor-Positive Early Breast Cancer.
Yee-Ming Cheung, Sabashini K Ramchand, Belinda Yeo, Mathis Grossmann.
J Endocr Soc, 2019 Jul 02; 3(7). PMID: 31259291    Free PMC article.
Highlights of the 16th St Gallen International Breast Cancer Conference, Vienna, Austria, 20-23 March 2019: personalised treatments for patients with early breast cancer.
Consuelo Morigi.
Ecancermedicalscience, 2019 Jul 10; 13. PMID: 31281421    Free PMC article.
Cancer Treatment-Related Infertility: A Critical Review of the Evidence.
Philip D Poorvu, A Lindsay Frazier, +6 authors, Ann H Partridge.
JNCI Cancer Spectr, 2019 Jul 31; 3(1). PMID: 31360893    Free PMC article.
Endocrine Therapy in Early Breast Cancer.
Katja Krauss, Elmar Stickeler.
Breast Care (Basel), 2020 Sep 29; 15(4). PMID: 32982643    Free PMC article.
Do we still need breast cancer screening in the era of targeted therapies and precision medicine?
Rubina Manuela Trimboli, Paolo Giorgi Rossi, +4 authors, Francesco Sardanelli.
Insights Imaging, 2020 Sep 26; 11(1). PMID: 32975658    Free PMC article.
Management of Breast Cancer During the COVID-19 Pandemic: A Stage- and Subtype-Specific Approach.
Jennifer Y Sheng, Cesar A Santa-Maria, +18 authors, Karen L Smith.
JCO Oncol Pract, 2020 Jul 01; 16(10). PMID: 32603252    Free PMC article.
Comparison of Endocrine Therapies in Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Locally Advanced or Metastatic Breast Cancer: A Network Meta-Analysis.
Siqi Liu, Xin Sun, Xiaohui Xu, Fangcai Lin.
J Breast Cancer, 2020 Nov 07; 23(5). PMID: 33154823    Free PMC article.
Change in Estradiol Levels among Premenopausal Patients with Breast Cancer Treated Using Leuprolide Acetate 11.25 Milligrams 3-Month Depot and Tamoxifen.
Young-Jin Lee, Zhen-Yu Wu, +10 authors, BeomSeok Ko.
J Breast Cancer, 2020 Nov 07; 23(5). PMID: 33154830    Free PMC article.
Landmark trials in the medical oncology management of early stage breast cancer.
Whitney Hensing, Cesar A Santa-Maria, Lindsay L Peterson, Jennifer Y Sheng.
Semin Oncol, 2020 Sep 17; 47(5). PMID: 32933761    Free PMC article.
Simplified phenotyping of CYP2D6 for tamoxifen treatment using the N-desmethyl-tamoxifen/ endoxifen ratio.
Clara Inkyung Lee, Siew Kee Low, +14 authors, Howard Gurney.
Breast, 2020 Nov 09; 54. PMID: 33161337    Free PMC article.
HER2 positivity is not associated with adverse prognosis in high-risk estrogen receptor-positive early breast cancer patients treated with chemotherapy and trastuzumab.
Shuai Li, Jiayi Wu, +6 authors, Kunwei Shen.
Breast, 2020 Nov 10; 54. PMID: 33166784    Free PMC article.
Therapeutic Strategies for the Management of Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Positive (HR+/HER2+) Breast Cancer: A Review of the Current Literature.
Eirini Thanopoulou, Leila Khader, +5 authors, Valentina Guarneri.
Cancers (Basel), 2020 Nov 14; 12(11). PMID: 33182657    Free PMC article.