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TPOAb and thyroid function are not associated with breast cancer outcome: evidence from a large-scale study using data from the taxotere as adjuvant chemotherapy trial (TACT, CRUK01/001)

Muller, Ilaria, Kilburn, Lucy S., Taylor, Peter N., Barrett-Lee, Peter J., Bliss, Judith M., Ellis, Paul, Ludgate, Marian E. and Dayan, Colin M. 2017. TPOAb and thyroid function are not associated with breast cancer outcome: evidence from a large-scale study using data from the taxotere as adjuvant chemotherapy trial (TACT, CRUK01/001). European Thyroid Journal 6 (4) , pp. 197-207. 10.1159/000460246

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Abstract

Background: Small-scale studies correlated the presence of thyroid autoimmunity with both improved or worsened breast cancer outcome. Objectives: We aimed to clarify this association in a large cohort using the phase III, randomized, controlled Taxotere as Adjuvant Chemotherapy Trial (TACT, CRUK01/001). Methods: TACT women >18 years old with node-positive or high-risk node-negative early breast cancer (pT1–3a, pN0–1, M0), with stored plasma (n = 1,974), taken 15.5 (median; IQR 7.0–24.0) months after breast surgery were studied. Patients had also received chemotherapy (100%), radiotherapy (1,745/1,974; 88.4%), hormonal therapy (1,378/ 1,974; 69.8%), or trastuzumab (48/1,974; 2.4%). History of thyroid diseases and/or related treatments was not available. The prognostic significance of autoantibodies to thyroid peroxidase (TPOAb; positive ≥6 kIU/L), free-thyroxine and thyrotropin (combined: euthyroid, hypothyroid, hyperthyroid) was evaluated for disease-free survival (DFS), overall-survival (OS), and time-to-recurrence (TTR), with Cox regression models in univariate and multivariable analyses. The extended median follow-up was 97.5 months. Results: No difference in DFS was found by TPOAb status (unadjusted hazard ratio [HR]: 0.97, 95%CI: 0.78–1.19; p = 0.75) and/or thyroid function (unadjusted HR [hypothyroid vs. euthyroid]: 1.15, 95% CI: 0.79–1.68; p = 0.46; unadjusted HR [hyperthyroid vs. euthyroid]: 1.14, 95% CI: 0.82–1.61; p = 0.44). Similar results were obtained for OS, TTR, multivariable analyses, when TPOAb titre by tertiles was considered, and in a subgroup of 123 patients with plasma collected before adjuvant treatments. Conclusions: No evidence for a prognostic role of TPOAb and/or thyroid function in moderate-to-high-risk early breast cancer was found in the largest and longest observational study to date.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Karger
ISSN: 2235-0640
Date of First Compliant Deposit: 15 August 2017
Date of Acceptance: 7 February 2017
Last Modified: 27 Jul 2019 21:37
URI: http://orca.cf.ac.uk/id/eprint/103627

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