Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer

Anouk K. M. Claessens, Frans L. G. Erdkamp, Marta Lopez-Yurda, Jeanette M. Bouma, Jeany M. Rademaker-Lakhai, Aafke H. Honkoop, Hiltje de Graaf, Vivianne C. G. Tjan-Heijnen, Monique E. M. M. Bos*, Dutch Breast Canc Res Grp BOOG

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)

Abstract

Background: Previously, we showed that reintroduction of the same (first-line) chemotherapy at progression could only partially make up for the loss in efficacy as compared to continuously delivered first-line chemotherapy. Here, we report the probability of starting second-line study chemotherapy in the Stop&Go trial, and the progression-free survival (PFS) and overall survival (OS) of patients who received both the first- and second-line treatment in an intermittent versus continuous schedule. Methods: First-line chemotherapy comprised paclitaxel plus bevacizumab, second-line capecitabine or non-pegylated liposomal doxorubicin, given per treatment line as two times four cycles (intermittent) or as eight consecutive cycles (continuous). Results: Of the 420 patients who started first-line treatment within the Stop&Go trial (210:210), a total of 270 patients continued on second-line study treatment (64% of all), which consisted of capecitabine in 201 patients and of non-pegylated liposomal doxorubicin in 69 patients, evenly distributed between the treatment arms. Median PFS was 3.7 versus 5.0 months (HR 1.07; 95% CI: 0.82-1.38) and median OS 10.9 versus 12.4 months (HR 1.27; 95% CI: 0.98-1.66) for intermittent versus continuous second-line chemotherapy. Second-line PFS was positively influenced by prior hormonal therapy for metastatic disease and longer first-line PFS duration, while triple-negative tumor status had a negative influence. Patients with a shorter time to progression (TTP) in first-line (

Original languageEnglish
Pages (from-to)713-722
Number of pages10
JournalActa Oncologica
Volume59
Issue number6
DOIs
Publication statusPublished - 2 Jun 2020

Keywords

  • METRONOMIC CHEMOTHERAPY
  • 1ST-LINE TREATMENT
  • CLINICAL-OUTCOMES
  • TREATMENT PATTERNS
  • OPEN-LABEL
  • CYCLOPHOSPHAMIDE
  • CAPECITABINE
  • BENEFIT
  • BEVACIZUMAB
  • SURVIVAL

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