In real life, one-quarter of patients with hormone receptor-positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium

D.J.A. Lobbezoo, R.J.W. van Kampen, A. C. Voogd, M. W. Dercksen, F. van den Berkmortel, T. J. Smilde, A. J. van de Wouw, F. P. J. Peters, J. M. G. H. van Riel, N. A. J. B. Peters, M. de Boer, P. G. M. Peer, V. C. G. Tjan-Heijnen*

*Corresponding author for this work

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Abstract

Background: The objective of this study wasto present initial systemic treatment choices and the outcome of hormone receptor-positive(HR+) metastaticbreastcancer.
Patients and methods: All the 815 consecutive patients diagnosed with metastatic breast cancer in 2007–2009 in eight participating hospitals were identified. From the 611 patients with HR+ disease, a total of 520 patients with HER2-negative(HER2−)breastcancerwereincluded.Initial palliativesystemictreatment wasregistered. Progression-free survival (PFS) and overall survival (OS) per initial palliative systemic therapy were obtained using the Kaplan–Meier method andcomparedusingthe log-rank test.
Results: From the total of 520 patients with HR+/HER2− metastatic breast cancer, 482 patients (93%) received any palliative systemic therapy. Patients that received initial chemotherapy (n=116) were significantly younger, had less comorbidity,had received more prioradjuvant systemic therapyand wereless likely tohave bonemetastasis onlycompared with patients that received initial endocrine therapy (n=366). Median PFS of initial palliative chemotherapy was 5.3 months [95% confidence interval (CI) 4.2–6.2] and of initial endocrine therapy 13.3 months (95% CI 11.3–15.5), with a median OS of 16.1 and 36.9 months, respectively. Initial chemotherapy was also associated with worse outcome in termsofPFSand OSafteradjustment forprognostic factors.
Conclusions: A high percentage of patients with HR+ disease received initial palliative chemotherapy, which was associated withworseoutcome,evenafteradjustment ofrelevant prognosticfactors.
Original languageEnglish
Pages (from-to)256-262
Number of pages7
JournalAnnals of Oncology
Volume27
Issue number2
DOIs
Publication statusPublished - Feb 2016

Keywords

  • metastatic breast cancer
  • chemotherapy
  • endocrine therapy
  • outcome
  • hormone receptor

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