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Clinical Trial
. 2025 Feb;10(2):104154.
doi: 10.1016/j.esmoop.2025.104154. Epub 2025 Feb 7.

The prognostic and predictive value of the luminal-like subtype in hormone receptor-positive breast cancer: an analysis of the DATA trial

S W M Lammers  1 , S M E Geurts  2 , K E P E Hermans  2 , L F S Kooreman  3 , A C P Swinkels  4 , C H Smorenburg  5 , M J C van der Sangen  6 , J R Kroep  7 , A H Honkoop  8 , F W P J van den Berkmortel  9 , W K de Roos  10 , S C Linn  11 , A L T Imholz  12 , I J H Vriens  2 , V C G Tjan-Heijnen  13 ; Dutch Breast Cancer Research Group (BOOG) for the DATA investigators
Affiliations
Clinical Trial

The prognostic and predictive value of the luminal-like subtype in hormone receptor-positive breast cancer: an analysis of the DATA trial

S W M Lammers et al. ESMO Open. 2025 Feb.

Abstract

Background: This study determines the prognostic value of the luminal-like subtype in patients with hormone receptor-positive breast cancer and explores whether the efficacy of extended anastrozole therapy differs between patients with luminal A-like versus luminal B-like tumours.

Materials and methods: The phase III DATA study (NCT00301457) examined the efficacy of 6 versus 3 years of anastrozole in postmenopausal women with early-stage hormone receptor-positive breast cancer who had received 2-3 years of tamoxifen. Patients with available formalin-fixed paraffin-embedded tissue blocks were identified and classified by immunohistochemical luminal-like subtype. Distant recurrence (DR) and breast cancer-specific mortality (BCSM) were compared by luminal-like subtype and treatment arm using competing risk methods.

Results: This study included 788 patients: 491 had a luminal A-like tumour and 297 had a luminal B-like tumour. The median follow-up time was 13.1 years. Patients with luminal B-like tumours experienced a higher risk of DR [subdistribution hazard ratio (sHR) 1.44, 95% confidence interval (CI) 1.03-2.01, P = 0.03] and BCSM (sHR 1.68, 95% CI 1.15-2.45, P = 0.008) than patients with luminal A-like tumours. The efficacy of extended anastrozole therapy differed between patients with luminal A-like tumours (DR: sHR 0.51, 95% CI 0.30-0.88, P = 0.02; BCSM: sHR 0.39, 95% CI 0.19-0.82, P = 0.01) and patients with luminal B-like tumours (DR: sHR 2.09, 95% CI 0.96-4.53, P = 0.06; BCSM: sHR 2.36, 95% CI 0.80-7.00, P = 0.12) (P-interaction = 0.03 and P-interaction = 0.06, respectively).

Conclusion: In patients with hormone receptor-positive breast cancer, the luminal B-like subtype was associated with a significantly worse prognosis when compared with the luminal A-like subtype. Extended anastrozole therapy halved the risk of DR and BCSM in patients with luminal A-like tumours, whereas no effect was seen in patients with luminal B-like tumours.

Keywords: Ki-67 antigen; aromatase inhibitors; breast neoplasms; luminal-like subtype; prognosis.

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Figures

Figure 1
Figure 1
Distant recurrence (DR) (A), breast cancer-specific mortality (BCSM) (B), disease-free survival (DFS) (C), and overall survival (OS) (D) according to luminal-like subtype. CI, confidence interval.
Figure 2
Figure 2
Adapted distant recurrence (aDR) in patients with luminal A-like tumours (A) and patients with luminal B-like tumours (B) and adapted breast cancer-specific mortality (aBCSM) in patients with luminal A-like tumours (C) and patients with luminal B-like tumours (D) according to assigned treatment from 3 years after randomisation onwards. CI, confidence interval.
Figure 3
Figure 3
Multivariable analyses of adapted distant recurrence, adapted breast cancer-specific mortality, adapted disease-free survival, and adapted overall survival evaluating the efficacy of 6 versus 3 years of anastrozole from 3 years after randomisation onwards, stratified by luminal-like subtype. CI, confidence interval; s(HR), subdistribution hazard ratio.aAnalyses were adjusted for age, tumour status, nodal status, histology, and prior chemotherapy.
See this image and copyright information in PMC

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