Evidence mapPaperPMID 26706833Full record

Trial reportMolecular oncology2016

The influence of insulin-like Growth Factor-1-Receptor expression and endocrine treatment on clinical outcome of postmenopausal hormone receptor positive breast cancer patients: A Dutch TEAM substudy analysis.

Charla C Engels, Nienke A de Glas, Anita Sajet, Esther Bastiaannet, Vincent T H B M Smit, Peter J K Kuppen, Caroline Seynaeve, Cornelis J H van de Velde, Gerrit Jan Liefers

Open access · bronzeAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Molecular oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 22 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Charla C EngelsDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Nienke A de GlasDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology & Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Anita SajetDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Esther BastiaannetDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Gerontology & Geriatrics, Leiden University Medical Center, Leiden, The Netherlands.
Vincent T H B M SmitDepartment of Pathology, Leiden University Medical Center, Leiden, The Netherlands.
Peter J K KuppenDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Caroline SeynaeveDepartment of Medical Oncology, Erasmus University Medical Center Cancer Institute, Rotterdam, The Netherlands.
Cornelis J H van de VeldeDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Gerrit Jan LiefersDepartment of Surgery, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: g.j.liefers@lumc.nl.
Leiden University Medical Center · NLErasmus MC · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSignaling via the Insulin-like Growth Factor type 1 Receptor (IGF1R) plays a crucial role in cancer development. In breast cancer (BC), IGF1R and estrogen receptor expression are correlated. In this current study we explored the hypothesis that postmenopausal hormone receptor positive (HR+ve) BC patients with high IGF1R tumor expression still have estrogen driven IGF1R stimulated tumor growth when treated with tamoxifen, resulting in detrimental clinical outcome compared to patients treated with exemestane. Additionally, we assessed the added value of metformin as this drug may lower IGF1R stimulation.

methodsOf 2,446 Dutch TEAM patients, randomized to either exemestane for 5 years or sequential treatment (tamoxifen for 2-3 years followed by exemestane for another 3-2 years) tumor tissue microarray sections were immunohistochemically stained for IGF1R. Overall Survival (OS), Breast Cancer specific Survival (BCSS) and Relapse-Free Survival (RFS) were assessed in patient subgroups with low and high IGF1R expression, and in patients with or without metformin use.

resultsHigh IGF1R tumor expression was significantly associated with exemestane therapy for RFS (Hazard Ratio (HR) 0.74, 95% Confidence Interval (CI) 0.58-0.95, p = 0.02). In addition, the combination of metformin with exemestane resulted in improved efficacy, yielding a 5-yrs RFS of 95% (HR 0.32, 95% CI 0.10-1.00, p = 0.02, compared to sequential treatment). No relation was observed in tumors with low IGF-1R expression.

conclusionThis study suggests IGF1R as a potential biomarker of improved clinical outcome in HR+ve BC patients treated with exemestane. Adding metformin to exemestane treatment may add to this effect.

Indexed as

Breast NeoplasmsAgedBiomarkers, TumorDisease-Free SurvivalFemaleFollow-Up StudiesGene Expression Regulation, NeoplasticHumansMiddle AgedNeoplasm ProteinsNetherlandsPostmenopauseReceptor, IGF Type 1Receptors, SomatomedinSurvival RateTamoxifenBiomarkers, TumorIGF1R protein, humanNeoplasm ProteinsReceptor, IGF Type 1Receptors, SomatomedinTamoxifenBreast cancerClinical outcomeEndocrine treatmentHormone receptorIGF1 receptorMetformin

Identifiers

PMID26706833
PMCPMC5423148
OpenAlexW1865453307

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.