Efficacy and clinical outcome of chemotherapy and endocrine therapy as first-line treatment in patients with hormone receptor-positive HER2-negative metastatic breast cancer.
10.1097/CM9.0000000000002676
- Author:
Yang YUAN
1
;
Shaohua ZHANG
2
;
Tao WANG
1
;
Li BIAN
2
;
Min YAN
3
;
Yongmei YIN
4
;
Yuhua SONG
5
;
Yi WEN
6
;
Jianbin LI
2
;
Zefei JIANG
2
Author Information
1. Department of Oncology No. 4 Ward, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100071, China.
2. Department of Oncology No. 3 Ward, The Fifth Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100071, China.
3. Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan 450008 China.
4. Department of Breast Cancer, Jiangsu Province Hospital & The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029 China.
5. Department of Breast Cancer Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 260000 China.
6. Medical Department, Medpion (Beijing) Medical Technology Co., Ltd, Beijing 100062 China.
- Publication Type:Journal Article
- MeSH:
Humans;
Female;
Breast Neoplasms/metabolism*;
Receptor, ErbB-2/metabolism*;
Progression-Free Survival;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*;
Disease Progression;
Treatment Outcome
- From:
Chinese Medical Journal
2023;136(12):1459-1467
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:Endocrine therapy (ET) and ET-based regimens are the preferred first-line treatment options for hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer (HR+/HER2- MBC), while chemotherapy (CT) is commonly used in clinical practice. The aim of this study was to investigate the efficacy and clinical outcome of ET and CT as first-line treatment in Chinese patients with HR+/HER2- MBC.
METHODS:Patients diagnosed with HR+/HER2-MBC between January 1st, 1996 and September 30th, 2018 were screened from the Chinese Society of Clinical Oncology Breast Cancer database. The initial and maintenance first-line treatment, progression-free survival (PFS), and overall survival (OS) were analyzed.
RESULTS:Among the 1877 included patients, 1215 (64.7%) received CT and 662 (35.3%) received ET as initial first-line treatment. There were no statistically significant differences in PFS and OS between patients receiving ET and CT as initial first-line treatment in the total population (PFS: 12.0 vs. 11.0 months, P = 0.22; OS: 54.0 vs . 49.0 months, P =0.09) and propensity score matched population. For patients without disease progression after at least 3 months of initial therapy, maintenance ET following initial CT (CT-ET cohort, n = 449) and continuous schedule of ET (ET cohort, n = 527) had longer PFS than continuous schedule of CT (CT cohort, n = 406) in the total population (CT-ET cohort vs. CT cohort: 17.0 vs . 8.5 months; P <0.01; ET cohort vs . CT cohort: 14.0 vs . 8.5 months; P <0.01) and propensity score matched population. OS in the three cohorts yielded the same results as PFS.
CONCLUSIONS:ET was associated with similar clinical outcome to CT as initial first-line treatment. For patients without disease progression after initial CT, switching to maintenance ET showed superiority in clinical outcome over continuous schedule of CT.
