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    POWERPIINC (PreOperative Window of Endocrine TheRapy Provides Information to Increase Compliance) trial: Changes in tumor proliferation index and quality of life with 7 days of preoperative tamoxifen

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    Author
    Cohen, Adam L.
    Factor, Rachel E.
    Mooney, Kathi
    Salama, Mohamed E.
    Wade, Mark
    Serpico, Victoria
    Ostrander, Emily
    Nelson, Edward
    Porretta, Jane
    Matsen, Cindy
    Bernard, Philip
    Boucher, Ken
    Neumayer, Leigh
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    Affiliation
    Department of Surgery, University of Arizona
    Issue Date
    2017-02
    Keywords
    Tamoxifen
    Ki-67 antigen
    Neoadjuvant therapy
    Breast neoplasms
    
    Metadata
    Show full item record
    Publisher
    CHURCHILL LIVINGSTONE
    Citation
    POWERPIINC (PreOperative Window of Endocrine TheRapy Provides Information to Increase Compliance) trial: Changes in tumor proliferation index and quality of life with 7 days of preoperative tamoxifen 2017, 31:219 The Breast
    Journal
    The Breast
    Rights
    © 2016 The Authors. Published by Elsevier Ltd.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Objectives: A decrease in Ki67 during neoadjuvant therapy predicts response to tamoxifen. Previous trials have shown a decreased Ki67 in breast tumors with as little as two or more weeks of preoperative tamoxifen. Shortening the preoperative treatment time in window of opportunity clinical trials makes these trials more attractive to women. POWERPIINC examined the effect of 7 days of preoperative tamoxifen on breast tumor proliferation and patient symptoms. Methods: Women with untreated stage I/II, ER-positive, invasive breast cancer with no contraindications to tamoxifen were enrolled. Women received 20 mg of tamoxifen for 7 days up to the day of surgery. Proliferation was assessed by Ki67 immunohistochemistry before and after 7 days of tamoxifen. Symptoms and QOL were assessed by the FACT-ES and MENQOL. Adherence was measured by pill counts. Results: 52 women were enrolled, and 44 were evaluable for Ki67. The median age was 58.5 years, and the median tumor diameter was 1.2 cm. Most women (73%) were post-menopausal. Most tumors were PR positive (88%) and HER2-negative (92%). The Ki67 decreased by a geometric mean of 40% (95% CI 29%-63%), and 73% (95% CI 57%-85%) of women had tumors with decreased proliferation (p = 0.0001 by paired t-test). Adherence to taking tamoxifen during the preoperative period was 100%. Women reported minimal bother from psychosocial or physical symptoms at baseline or on the day of surgery. Conclusion: Seven days of tamoxifen showed a similar relative decrease in Ki67 as that reported for longer courses, was acceptable to women, and could be considered for window of opportunity studies.
    Note
    Published open access.
    ISSN
    09609776
    DOI
    10.1016/j.breast.2016.11.016
    Version
    Final published version
    Sponsors
    National Institutes of Health [P30CA042014]
    Additional Links
    http://linkinghub.elsevier.com/retrieve/pii/S0960977616302508
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.breast.2016.11.016
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