Treatment sequences and survival outcomes in advanced HR + HER2- breast cancer patients: a real-world cohort.

IF 3 3区医学 Q2 ONCOLOGY Breast Cancer Research and Treatment Pub Date : 2024-11-07 DOI:10.1007/s10549-024-07542-0

Cornelia A M Almekinders, Lishi Lin, Jos H Beijnen, Gabe S Sonke, Alwin D R Huitema, Vincent O Dezentjé

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Abstract

Purpose: Palliative treatment options for HR + HER2- advanced breast cancer (ABC) patients have increased, but data is lacking about the optimal treatment sequence. We used real-world data from a comprehensive cancer center to describe applied treatment sequences and we determined treatment-related and survival outcomes.

Methods: Patients aged 18 years and older with HR + HER2- ABC treated with systemic treatment were included in this historic cohort study. Sequential treatment schedules, time to treatment discontinuation, time to chemotherapy, and overall survival (OS) were determined, stratified by first-line treatment.

Results: 202 patients were included. They received a total of 650 treatment lines (median 3; range: 1-11). 91 (45%), 25 (12%), 24 (12%), 28 (14%), 22 (11%) and 12 (6%) patients started first-line treatment with non-steroidal aromatase inhibitors (NSAI), NSAI + cyclin dependent kinase 4/6-inhibitors (CDK4/6i), fulvestrant + CDK4/6i, tamoxifen, chemotherapy and other treatment, respectively. 10, 13, and 14 different treatment regimens were given in first, second and third-line, respectively. Of the patients who started first-line NSAI monotherapy (n = 91), 3 (3%) died before receiving second-line treatment.

Conclusion: In this real-world cohort, we observed a wide variety of different treatment sequences applied in daily clinical practice, some of which were in discordance with the current guidelines. Fear that patients may never get around to treatment with CDK4/6i if a patient did not start with a CDK4/6i was not supported by our study results.

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晚期HR + HER2-乳腺癌患者的治疗顺序和生存结果：真实世界队列。

目的：HR + HER2-晚期乳腺癌（ABC）患者的姑息治疗选择有所增加，但缺乏有关最佳治疗顺序的数据。我们利用一家综合癌症中心的真实数据来描述应用的治疗顺序，并确定治疗相关的结果和生存率：这项历史性队列研究纳入了 18 岁及以上接受全身治疗的 HR + HER2- ABC 患者。结果：共纳入 202 例患者，他们共接受了 650 个疗程的治疗。结果：共纳入 202 名患者，他们共接受了 650 次治疗（中位数：3；范围：1-11）。91名（45%）、25名（12%）、24名（12%）、28名（14%）、22名（11%）和12名（6%）患者分别接受了非甾体类芳香化酶抑制剂（NSAI）、NSAI+细胞周期蛋白依赖激酶4/6抑制剂（CDK4/6i）、氟维司群+CDK4/6i、他莫昔芬、化疗和其他治疗。一线、二线和三线分别采用了10种、13种和14种不同的治疗方案。在开始一线非甾体抗炎药物单药治疗的患者（n = 91）中，有3人（3%）在接受二线治疗前死亡：在这个真实世界的队列中，我们观察到在日常临床实践中应用了多种不同的治疗顺序，其中一些与现行指南不一致。我们的研究结果并不支持这样的担忧，即如果患者没有从 CDK4/6i 开始治疗，就可能永远无法接受 CDK4/6i 治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.