First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study
Background: Endocrine therapy (ET) plus cyclin-dependent-kinases 4/6 inhibitors (CDK4/6i) represents the standard treatment for luminal-metastatic breast cancer (MBC). However, prospective head-to-head comparisons are still lacking for 1st line (L) options, and it is still crucial to define the best...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-06-01
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| Series: | Breast |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0960977621000291 |
| _version_ | 1819077208438734848 |
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| author | Debora Basile Lorenzo Gerratana Carla Corvaja Giacomo Pelizzari Giorgia Franceschin Elisa Bertoli Lorenza Palmero Diego Zara Martina Alberti Silvia Buriolla Lucia Da Ros Marta Bonotto Mauro Mansutti Simon Spazzapan Marika Cinausero Alessandro Marco Minisini Gianpiero Fasola Fabio Puglisi |
| author_facet | Debora Basile Lorenzo Gerratana Carla Corvaja Giacomo Pelizzari Giorgia Franceschin Elisa Bertoli Lorenza Palmero Diego Zara Martina Alberti Silvia Buriolla Lucia Da Ros Marta Bonotto Mauro Mansutti Simon Spazzapan Marika Cinausero Alessandro Marco Minisini Gianpiero Fasola Fabio Puglisi |
| author_sort | Debora Basile |
| collection | DOAJ |
| description | Background: Endocrine therapy (ET) plus cyclin-dependent-kinases 4/6 inhibitors (CDK4/6i) represents the standard treatment for luminal-metastatic breast cancer (MBC). However, prospective head-to-head comparisons are still lacking for 1st line (L) options, and it is still crucial to define the best strategy between 1st and 2nd L. Materials and methods: 717 consecutive luminal-MBC pts treated between 2008 and 2020 were analyzed at the Oncology Department of Aviano and Udine, Italy. Differences about survival outcomes (OS, PFS and PPS) were tested by log-rank test. The attrition rate (AR) between 1st and 2ndL was calculated. Results: At 1stL, pts were treated with ET (49%), chemotherapy (CT) (31%) and ET-CDKi (20%) while, at 2ndL, 33% received ET, 33% CT and 8% ET-CDKi. Overall AR was 10%, 7% for CT, 8% for ET and 17% for ET-CDKi. By multivariate analysis, 1stL ET-CDK4/6i showed a better mPFS1 and OS. Moreover, 2ndL ET-CDK4/6i demonstrated better mPFS2 compared to ET and CT. Notably, 1stL ET-CDKi resulted in higher mPFS than 2ndL ET-CDKi. Intriguingly, 1stL ET-CDK4/6i was associated with worse mPPS compared to CT and ET. Secondarily, 1stL ET-CDK4/6i followed by CT had worse OS compared to 1stL ET-CDK4/6i followed by ET. Notably, none of baseline characteristics at 2ndL influenced 2ndL treatment choice (ET vs. CT) after ET-CDKi. Conclusion: Our real-world data demonstrated that ET-CDKi represents the best option for 1stL luminal-MBC compared to ET and CT. Also, the present study pointed out that 2ndL ET, potentially combined with other molecules, could be a feasible option after CDK4/6i failure, postponing CT on later lines. |
| first_indexed | 2024-12-21T18:53:33Z |
| format | Article |
| id | doaj.art-ffca05a7c1374d128a76cb6fc5f88ba4 |
| institution | Directory Open Access Journal |
| issn | 1532-3080 |
| language | English |
| last_indexed | 2024-12-21T18:53:33Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Breast |
| spelling | doaj.art-ffca05a7c1374d128a76cb6fc5f88ba42022-12-21T18:53:41ZengElsevierBreast1532-30802021-06-0157104112First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world studyDebora Basile0Lorenzo Gerratana1Carla Corvaja2Giacomo Pelizzari3Giorgia Franceschin4Elisa Bertoli5Lorenza Palmero6Diego Zara7Martina Alberti8Silvia Buriolla9Lucia Da Ros10Marta Bonotto11Mauro Mansutti12Simon Spazzapan13Marika Cinausero14Alessandro Marco Minisini15Gianpiero Fasola16Fabio Puglisi17Department of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy; Corresponding author. Department of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, Italy.Department of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyDepartment of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Oncology, ASUFC Santa Maria Della Misericordia, Udine, ItalyDepartment of Medicine, University of Udine, 33100, Udine, Italy; Department of Medical Oncology, Unit of Medical Oncology and Cancer Prevention, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081, Aviano, ItalyBackground: Endocrine therapy (ET) plus cyclin-dependent-kinases 4/6 inhibitors (CDK4/6i) represents the standard treatment for luminal-metastatic breast cancer (MBC). However, prospective head-to-head comparisons are still lacking for 1st line (L) options, and it is still crucial to define the best strategy between 1st and 2nd L. Materials and methods: 717 consecutive luminal-MBC pts treated between 2008 and 2020 were analyzed at the Oncology Department of Aviano and Udine, Italy. Differences about survival outcomes (OS, PFS and PPS) were tested by log-rank test. The attrition rate (AR) between 1st and 2ndL was calculated. Results: At 1stL, pts were treated with ET (49%), chemotherapy (CT) (31%) and ET-CDKi (20%) while, at 2ndL, 33% received ET, 33% CT and 8% ET-CDKi. Overall AR was 10%, 7% for CT, 8% for ET and 17% for ET-CDKi. By multivariate analysis, 1stL ET-CDK4/6i showed a better mPFS1 and OS. Moreover, 2ndL ET-CDK4/6i demonstrated better mPFS2 compared to ET and CT. Notably, 1stL ET-CDKi resulted in higher mPFS than 2ndL ET-CDKi. Intriguingly, 1stL ET-CDK4/6i was associated with worse mPPS compared to CT and ET. Secondarily, 1stL ET-CDK4/6i followed by CT had worse OS compared to 1stL ET-CDK4/6i followed by ET. Notably, none of baseline characteristics at 2ndL influenced 2ndL treatment choice (ET vs. CT) after ET-CDKi. Conclusion: Our real-world data demonstrated that ET-CDKi represents the best option for 1stL luminal-MBC compared to ET and CT. Also, the present study pointed out that 2ndL ET, potentially combined with other molecules, could be a feasible option after CDK4/6i failure, postponing CT on later lines.http://www.sciencedirect.com/science/article/pii/S0960977621000291Metastatic luminal breast cancerTreatment strategiesCDK4/6 inhibitorsMBC |
| spellingShingle | Debora Basile Lorenzo Gerratana Carla Corvaja Giacomo Pelizzari Giorgia Franceschin Elisa Bertoli Lorenza Palmero Diego Zara Martina Alberti Silvia Buriolla Lucia Da Ros Marta Bonotto Mauro Mansutti Simon Spazzapan Marika Cinausero Alessandro Marco Minisini Gianpiero Fasola Fabio Puglisi First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study Breast Metastatic luminal breast cancer Treatment strategies CDK4/6 inhibitors MBC |
| title | First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study |
| title_full | First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study |
| title_fullStr | First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study |
| title_full_unstemmed | First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study |
| title_short | First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study |
| title_sort | first and second line treatment strategies for hormone receptor hr positive her2 negative metastatic breast cancer a real world study |
| topic | Metastatic luminal breast cancer Treatment strategies CDK4/6 inhibitors MBC |
| url | http://www.sciencedirect.com/science/article/pii/S0960977621000291 |
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