Breast and Medical Oncology Division , National Cancer Center Hospital, 5-1-1 Tsukiji, Chuou-ku, Tokyo, 104-0045, Japan.
Breast Cancer. 2013 Apr;20(2):145-51. doi: 10.1007/s12282-011-0320-3. Epub 2011 Dec 3.
The purpose of this work was identify potential prognostic factors for survival in patients with primary metastatic hormone receptor-positive breast cancer undergoing endocrine therapy (ET) as first-line treatment.
We investigated the clinical and pathological characteristics of 69 newly diagnosed stage IV hormone receptor-positive breast cancer patients undergoing ET between 1999 and 2009, and correlated these factors with disease progression and overall survival.
Multivariate regression analysis revealed that progesterone receptor (PgR) positivity (hazard ratio (HR) 0.248; p = 0.001) and clinical benefits of first-line ET (HR 0.386; p = 0.008) were significant prognostic factors for survival. When first-line ET was not effective, patients for whom second-line ET was effective survived significantly longer than those for whom second-line ET was not effective (median survival time, 45.3 vs. 25.8 months; p = 0.0411).
PgR positivity and clinical benefits of first-line ET were independent prognostic factors for patients with hormone receptor-positive stage IV breast cancer. Moreover, the benefits of second-line ET in patients with a tumor resistant to first-line ET suggests the existence of drug-specific resistance to ET.
本研究旨在确定激素受体阳性、接受内分泌治疗（ET）作为一线治疗的原发性转移性乳腺癌患者的生存预后相关的潜在因素。
我们分析了 1999 年至 2009 年间 69 例新诊断的激素受体阳性 IV 期乳腺癌患者的临床和病理特征，并将这些因素与疾病进展和总生存相关联。
多因素回归分析显示孕激素受体（PgR）阳性（风险比（HR）0.248；p = 0.001）和一线 ET 的临床获益（HR 0.386；p = 0.008）是生存的显著预后因素。当一线 ET 无效时，二线 ET 有效的患者的中位生存时间显著长于二线 ET 无效的患者（45.3 个月 vs. 25.8 个月；p = 0.0411）。
一线 ET 的 PgR 阳性和临床获益是激素受体阳性 IV 期乳腺癌患者的独立预后因素。此外，二线 ET 对一线 ET 耐药肿瘤患者的获益提示存在 ET 药物特异性耐药。
