Efficacy and Safety of Toremifene in Young Patients with Luminal Subtype Early Breast Cancer: A Retrospective Study

【Objective】 There is no study about toremifene in the treatment of young breast cancer patients.This study aimed to compare the efficacy and safety of toremifene for young premenopausal breast cancer patients.【Methods】 We retrospectively reviewed 247 young(≤35 years old) premenopausal Luminal type operable breast cancer patients,including 66 patients treated with toremifene and 181 patients treated with tamoxifen between January 2002 and October 2007.Survival was compared by Kaplan-Meier method with Log-rank test.Multivariate analysis was conducted by Cox hazard ratio regression model.【Results】 Median age for toremifene and tamoxifen were 33 years and 32 years,respectively.After median follow-up duration of 77.1 months,6-year diseasefree survival was not significantly different between tamoxifen and toremifene(77.0% vs 79.2%,respectively).Similarly,6-year overall survival was not significantly different between tamoxifen and toremifene(88.4% vs 87.4%,respectively).There was no difference between patients treated with toremifene versus tamoxifen in terms of overall survival(HR = 0.794;P = 0.589) and diseasefree survival(HR = 1.132;P = 0.686).Adverse events were similar in the two groups.Univariated analysis showed that tumor size,grade,stage and HER2 overexpression were associated with short disease-free survival.Progesterone receptor status might affect disease-free survival(P = 0.056).Lymphovascular invasion,positive lymph node and advanced stage predicted poor overall survival.Multivariate analysis showed that HER2 overexpression and progesterone receptor negative were associated with short disease-free survival.Advanced stage was a predictor for unfavorable overall survival.【Conclusion】 There was similar benefit in overall survival and disease-free survival in young premenopausal patients with operable breast cancer between patients receiving toremifene and tamoxifen.Further perspective clinical trials were needed to confirm the value of toremifene in adjuvant endocrine therapy for patients with premenopausal breast cancer.