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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

 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 
 JOURNAL OF CLINICAL ONCOLOGY, Vol.41(31) : 4864-4871, 2023-11 
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Antineoplastic Agents, Hormonal / adverse effects ; Antineoplastic Combined Chemotherapy Protocols / adverse effects ; Breast Neoplasms* ; Chemotherapy, Adjuvant / adverse effects ; Female ; Follow-Up Studies ; Humans ; Ovary ; Premenopause ; Tamoxifen* / adverse effects
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.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Il(김승일)
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
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