- Title
- Adjuvant ovarian suppression in premenopausal breast cancer
- Creator
- Francis, Prudence A.; Regan, Meredith M.; Fleming, Gini F.
- Relation
- The New England Journal of Medicine Vol. 372, Issue 17, p. 1673-1673
- Publisher Link
- http://dx.doi.org/10.1056/NEJMc1502618
- Publisher
- Massachusetts Medical Society
- Resource Type
- journal article
- Date
- 2015
- Description
- The authors reply: The reporting of the results of subgroup analyses in SOFT focused on clinical care–oriented trial hypotheses, with a forest plot summarizing the exploration of treatment efficacy heterogeneity according to key prognostic and treatment features. Planned subgroup analyses (Fig. S2 in the Supplementary Appendix, available with the full text of the article at NEJM.org) were undertaken to explore potential heterogeneity of treatment effect and should not be misinterpreted as testing treatment effects within multiple subgroups, nor should they be overinterpreted to include or exclude any specific subgroup from the possibility of treatment benefit. The use of prior chemotherapy in SOFT was a stratification factor that defined two distinct patient cohorts with different biologic and clinical hypotheses for the role of ovarian suppression. We recognize that chemotherapy use is not a reproducible factor as a proxy for risk of relapse but was a reasonable approximation thereof. Although it is possible that a theoretical, individual 45-year-old woman with a small, node-negative, grade 2, HER2-negative tumor who did not receive adjuvant chemotherapy might benefit from ovarian suppression, ovarian suppression should not be recommended routinely for all such premenopausal patients on the basis of the trial results. The no-chemotherapy cohort comprised women with a median age of 46 years, with predominantly small, node-negative, low-to-intermediate grade, HER2-negative tumors (Table 1 of the article), and the results in this cohort showed no benefit from the addition of ovarian suppression.
- Subject
- suppression ovarian function trial; adjuvant chemotherapy; ovarian suppression; tumours
- Identifier
- http://hdl.handle.net/1959.13/1319431
- Identifier
- uon:23862
- Identifier
- ISSN:1533-4406
- Language
- eng
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