Author:
Twelves Chris,Cheeseman Sue,Sopwith Will,Thompson Matthew,Riaz Majid,Ahat-Donker Necibe,Myland Melissa,Lee Adam,Przybysz Raymond,Turner Stuart,Hall Geoff,Perren Tim
Abstract
Abstract
Background
Study aimed to characterise treatment and outcomes for patients with hormone receptor positive (HR+), human epidermal growth factor 2 negative (HER2-) metastatic breast cancer (MBC) within a large regional cancer centre, as a benchmark for evaluating real-world impact of novel therapies.
Methods
Retrospective longitudinal cohort, using electronic patient records of adult females with a first diagnosis of HR+/HER2- MBC January 2012–March 2018.
Results
One hundred ninety-six women were identified with HR+/HER2- MBC. Median age was 67 years, 85.2% were post-menopausal and median time between primary diagnosis and metastasis was 5.4 years. Most (75.1%) patients received endocrine therapy as first line systemic treatment (1st LoT); use of 1st LoT chemotherapy halved between 2012 and 2017. Patients receiving 1st LoT chemotherapy were younger and more likely to have visceral metastasis (p < 0.01). Median OS was 29.5 months and significantly greater for patients with exclusively non-visceral metastasis (p < 0.01). The adjusted hazard ratio for death of patients with visceral (or CNS) metastasis was 1.91 relative to those with exclusively non-visceral metastasis.
Conclusions
Diverse endocrine therapies predominate as 1st LoT for patients with HR+/HER2- MBC, chemotherapy being associated with more aggressive disease in younger patients, emphasising the importance of using effective and tolerable therapies early.
Funder
Novartis Pharmaceuticals Corporation
Publisher
Springer Science and Business Media LLC
Subject
Cancer Research,Genetics,Oncology
Reference28 articles.
1. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci. 2001;98(19):10869–74.
2. Stenger M. Incidence of breast Cancer according to joint hormone receptor and HER2 status differs according to race/ethnicity and other factors - the ASCO post; 2014.
3. NICE. Managing advanced breast cancer. 2017 [cited 2017 Aug 31]. Available from: https://pathways.nice.org.uk/pathways/advanced-breast-cancer#path=view%3A/pathways/advanced-breast-cancer/managing-advanced-breast-cancer.xml&content=view-node%3Anodes-hrpos-and-her2neg
4. Howlader N, Altekruse S, Li C, Chen V, Clarke C, Ries L, et al. US incidence of breast cancer subtypes defined by joint hormone receptor and HER2 status. J Natl Cancer Inst. 2014;106(5). https://doi.org/10.1093/jnci/dju055.
5. Cardoso F, Senkus E, Costa A, Papadopoulos E, Aapro M, André F, et al. 4th ESO–ESMO international consensus guidelines for advanced breast Cancer (ABC 4)†. Ann Oncol. 2018;29(8):1634–57.
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