Characteristics, treatment patterns and survival of patients with high-risk early hormone receptor-positive breast cancer in French real-world settings: an exploratory study of the CANTO cohort☆

IF 7.1 2区 医学 Q1 ONCOLOGY ESMO Open Pub Date : 2024-12-01 DOI:10.1016/j.esmoop.2024.103994
F. Giugliano , A. Bertaut , J. Blanc , A.-L. Martin , C. Gaudin , M. Fournier , A. Kieffer , B. Sauterey , C. Levy , M. Campone , C. Tarpin , F. Lerebours , M.-A. Mouret-Reynier , G. Curigliano , F. André , B. Pistilli , E. Rassy
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Abstract

Background

Patients with hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer (HR+ BC) with unfavorable features have an increased risk of relapse and are currently candidate for additional treatment strategies. We evaluated the real-world clinicopathological characteristics, treatment patterns and survival outcomes of these patients within the CANcer TOxicities study (CANTO, NCT01993498).

Patients and methods

This is a retrospective analysis of the prospective data collected within CANTO between 2012 and 2022. Patients with high-risk HR+ BC were defined either by the identification of at least four positive axillary lymph nodes (LNs) or one to three positive axillary LNs with a tumor size ≥5 cm or histologic grade 3 (cohort 1). The definition 1-3 positive LNs with Ki-67 ≥20% was also considered (cohort 2). The Kaplan–Meier method was used for survival analysis.

Results

Patients with high-risk HR+ BC represented 15.0%-19.6% of HR+ BC (cohort 1 and 2, respectively) in the CANTO cohort. Of the 1266 patients in cohort 1, 617 patients (49.0%) had ≥4 LNs, 327 (26.0%) had tumor ≥5 cm and 727 (57.6%) had grade III tumors. 79.9% had a favorable Charlson comorbidity score and 88.1% stage II/IIIA. Patients with ≥10 LNs accounted for 11.8%. (Neo)adjuvant chemotherapy was administered in 94.2%. Endocrine therapy was prescribed in 97.3%, mostly with aromatase inhibitors and discontinued in 34.3%, mainly for adverse events. Patients enrolled at least 6 years before data extraction had a 5-year invasive disease-free survival and 5-year distant relapse-free survival of 79.9% [95% confidence interval (CI) 77.2% to 82.4%] and 83.5% (95% CI 80.9% to 85.7%), respectively.

Conclusions

This real-world study confirms that patients with HR+ BC and unfavorable clinicopathological features are at risk of relapse early in their adjuvant treatment trajectory, despite (neo)adjuvant chemotherapy. It is imperative to implement innovative treatment approaches for high-risk patients, ideally adding them as early as possible to the adjuvant treatment.
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法国真实世界环境中高危早期激素受体阳性乳腺癌患者的特征、治疗模式和生存:CANTO队列的探索性研究☆
激素受体阳性,人表皮生长因子受体2 (HER2)阴性乳腺癌(HR+ BC)具有不利特征的患者复发风险增加,目前是额外治疗策略的候选患者。我们在癌症毒性研究中评估了这些患者的临床病理特征、治疗模式和生存结果(CANTO, NCT01993498)。患者和方法这是对2012年至2022年CANTO期间收集的前瞻性数据的回顾性分析。高危HR+ BC患者定义为至少4个阳性腋下淋巴结(LNs)或1至3个阳性腋下淋巴结,肿瘤大小≥5cm或组织学分级为3(队列1)。定义为1-3个阳性LNs, Ki-67≥20%(队列2)也被考虑。结果CANTO队列中高危HR+ BC患者占HR+ BC患者的15.0% ~ 19.6%(队列1和队列2分别为15.0% ~ 19.6%)。在1266例队列患者中,617例(49.0%)患者≥4个LNs, 327例(26.0%)患者肿瘤≥5 cm, 727例(57.6%)患者为III级肿瘤。79.9%的Charlson合并症评分良好,88.1%为II/IIIA期。≥10个LNs的患者占11.8%。(Neo)辅助化疗占94.2%。97.3%的人接受内分泌治疗,主要是芳香化酶抑制剂,34.3%的人因不良事件而停药。在数据提取前至少6年入组的患者,5年无侵袭性疾病生存率为79.9%[95%可信区间(CI) 77.2% ~ 82.4%], 5年远端无复发生存率为83.5% (95% CI 80.9% ~ 85.7%)。结论:这项现实世界的研究证实,尽管(新)辅助化疗,HR+ BC和不良临床病理特征的患者在辅助治疗早期仍有复发的风险。对高危患者实施创新的治疗方法势在必行,最好尽早将其纳入辅助治疗。
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
ESMO Open
ESMO Open Medicine-Oncology
CiteScore
11.70
自引率
2.70%
发文量
255
审稿时长
10 weeks
期刊介绍: ESMO Open is the online-only, open access journal of the European Society for Medical Oncology (ESMO). It is a peer-reviewed publication dedicated to sharing high-quality medical research and educational materials from various fields of oncology. The journal specifically focuses on showcasing innovative clinical and translational cancer research. ESMO Open aims to publish a wide range of research articles covering all aspects of oncology, including experimental studies, translational research, diagnostic advancements, and therapeutic approaches. The content of the journal includes original research articles, insightful reviews, thought-provoking editorials, and correspondence. Moreover, the journal warmly welcomes the submission of phase I trials and meta-analyses. It also showcases reviews from significant ESMO conferences and meetings, as well as publishes important position statements on behalf of ESMO. Overall, ESMO Open offers a platform for scientists, clinicians, and researchers in the field of oncology to share their valuable insights and contribute to advancing the understanding and treatment of cancer. The journal serves as a source of up-to-date information and fosters collaboration within the oncology community.
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