Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier
Purpose: Evidence for optimizing the first-line chemotherapy for patients with metastatic triple-negative breast cancer (mTNBC) is lacking. This study assessed the utilization patterns of chemotherapy and associated survival outcomes in de novo mTNBC patients. Methods: Taiwan's cancer registry...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621001856 |
| _version_ | 1818873845829861376 |
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| author | Wei-Pang Chung Chun-Ting Yang Hsuan-Ying Chen Ching-Yen Su Hsin-Wei Su Huang-Tz Ou |
| author_facet | Wei-Pang Chung Chun-Ting Yang Hsuan-Ying Chen Ching-Yen Su Hsin-Wei Su Huang-Tz Ou |
| author_sort | Wei-Pang Chung |
| collection | DOAJ |
| description | Purpose: Evidence for optimizing the first-line chemotherapy for patients with metastatic triple-negative breast cancer (mTNBC) is lacking. This study assessed the utilization patterns of chemotherapy and associated survival outcomes in de novo mTNBC patients. Methods: Taiwan's cancer registry was utilized to extract study patients with newly-diagnosed breast cancer during 2011–2015 and confirmed metastatic triple-negative status.The patients’ medical records (e.g., diseases, treatments) and death status were obtained from the National Health Insurance Research Database. Utilization of first-line chemotherapy regimens was analyzed and associated survival outcomes were assessed using Cox models. Results: 93.60% of the mTNBC patients (n = 297) received chemotherapy, where combination regimens (75.54%) were more common than single-agent regimens (24.46%) in the first-line setting. A non-statistically lower all-cause death associated with combination versus single-agent chemotherapy (hazard ratio: 0.830 [0.589, 1.168]) was observed. Age was identified as a significant effect-modifier in treatment-associated survival outcomes (p = 0.008); younger patients (aged < 40 and 40–59 years) versus older patients (aged ≥ 60 years) had a lower all-cause mortality when receiving combination versus single-agent chemotherapy. A lower all-cause mortality associated with taxane- versus non-taxane-based therapy was revealed among those on single-agent chemotherapy (hazard ratio: 0.557 [0.311, 0.999]). Conclusion: Generally, single-agent and combination chemotherapies yielded comparable survival outcomes as the first-line treatment for de novo mTNBC. Younger patients may benefit more from combination regimens, in terms of better survival outcomes. Single-agent chemotherapy may be preferable as the first-line choice for elderly patients who are vulnerable to the toxicity of multiple chemotherapy agents. |
| first_indexed | 2024-12-19T13:01:11Z |
| format | Article |
| id | doaj.art-0cba5679d36c4cb8aa658a5283191ef5 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-19T13:01:11Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-0cba5679d36c4cb8aa658a5283191ef52022-12-21T20:20:14ZengElsevierJournal of the Formosan Medical Association0929-66462022-01-011211319328Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifierWei-Pang Chung0Chun-Ting Yang1Hsuan-Ying Chen2Ching-Yen Su3Hsin-Wei Su4Huang-Tz Ou5Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center of Applied Nanomedicine, National Cheng Kung University, Tainan, TaiwanInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, TaiwanMedical Division, Roche Products Ltd, Taipei, TaiwanMedical Division, Roche Products Ltd, Taipei, TaiwanInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan; Corresponding author. Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, 1 University Road, Tainan, 701, Taiwan. Fax: +886 6 2373149.Purpose: Evidence for optimizing the first-line chemotherapy for patients with metastatic triple-negative breast cancer (mTNBC) is lacking. This study assessed the utilization patterns of chemotherapy and associated survival outcomes in de novo mTNBC patients. Methods: Taiwan's cancer registry was utilized to extract study patients with newly-diagnosed breast cancer during 2011–2015 and confirmed metastatic triple-negative status.The patients’ medical records (e.g., diseases, treatments) and death status were obtained from the National Health Insurance Research Database. Utilization of first-line chemotherapy regimens was analyzed and associated survival outcomes were assessed using Cox models. Results: 93.60% of the mTNBC patients (n = 297) received chemotherapy, where combination regimens (75.54%) were more common than single-agent regimens (24.46%) in the first-line setting. A non-statistically lower all-cause death associated with combination versus single-agent chemotherapy (hazard ratio: 0.830 [0.589, 1.168]) was observed. Age was identified as a significant effect-modifier in treatment-associated survival outcomes (p = 0.008); younger patients (aged < 40 and 40–59 years) versus older patients (aged ≥ 60 years) had a lower all-cause mortality when receiving combination versus single-agent chemotherapy. A lower all-cause mortality associated with taxane- versus non-taxane-based therapy was revealed among those on single-agent chemotherapy (hazard ratio: 0.557 [0.311, 0.999]). Conclusion: Generally, single-agent and combination chemotherapies yielded comparable survival outcomes as the first-line treatment for de novo mTNBC. Younger patients may benefit more from combination regimens, in terms of better survival outcomes. Single-agent chemotherapy may be preferable as the first-line choice for elderly patients who are vulnerable to the toxicity of multiple chemotherapy agents.http://www.sciencedirect.com/science/article/pii/S0929664621001856AgeChemotherapySurvivalTriple-negative breast cancer |
| spellingShingle | Wei-Pang Chung Chun-Ting Yang Hsuan-Ying Chen Ching-Yen Su Hsin-Wei Su Huang-Tz Ou Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier Journal of the Formosan Medical Association Age Chemotherapy Survival Triple-negative breast cancer |
| title | Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier |
| title_full | Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier |
| title_fullStr | Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier |
| title_full_unstemmed | Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier |
| title_short | Treatment-associated survival outcomes in real-world patients with de novo metastatic triple-negative breast cancer: Age as a significant treatment effect-modifier |
| title_sort | treatment associated survival outcomes in real world patients with de novo metastatic triple negative breast cancer age as a significant treatment effect modifier |
| topic | Age Chemotherapy Survival Triple-negative breast cancer |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621001856 |
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