Galli Giulia, Tessari Anna, Porcu Luca, Bregni Giacomo, Paolini Biagio, Carcangiu Maria Luisa, Gennaro Massimiliano, De Santis Maria Carmen, Lozza Laura, de Braud Filippo, Di Cosimo Serena
Division of Medical Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, via G. Venezian 1, 20133, Milan, Italy.
Department of Cancer Biology and Genetics, The Ohio State University, 460 West 12th Avenue, Columbus, OH, USA.
Breast Cancer. 2017 Jul;24(4):635-641. doi: 10.1007/s12282-017-0751-6. Epub 2017 Jan 5.
Complete response (CR) in metastatic breast cancer (MBC) is rare. This study aims at analyzing the characteristics and outcome of MBC patients achieving CR.
We performed a cross-sectional analysis of clinical data from a consecutive series of MBC patients admitted at the Division of Medical Oncology of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, achieving CR following treatment for systemic disease and with at least 2 years of follow-up.
Seventy-six MBC patients with CR were identified during a calendar year. 47 patients (61.8%) achieved CR more than once, for a total of 123 cases. Median age at MBC diagnosis was 56 years (range 30-76). 52 patients (68.4%) presented with recurrent disease, 24 (31.6%) with de novo metastatic disease. The majority of patients (80.3%) had hormone receptor (HR) positive and 26 (34.2%) had HER2 overexpressing MBC. 54 patients (71.1%) had only one site of metastatic disease. 33 patients (43.4%) received a local approach as part of their treatment and 67 (54.5%) achieved CR during maintenance therapy. CRs were durable, as after a median follow-up of 8.3 years (interquartile range 5.8-11.0 years) 42 patients (55.3%) were alive with no evidence of disease.
Durable CRs can occur after systemic therapy alone or after combined systemic and local treatments. Most cases presented CR in the presence of limited disease spreading, not necessarily on first-line therapy. Our study highlights the crucial role of multidisciplinary approach to MBC and the benefit of maintenance treatment.
转移性乳腺癌（MBC）中的完全缓解（CR）很罕见。本研究旨在分析实现CR的MBC患者的特征和预后。
我们对意大利米兰 Fondazione IRCCS Istituto Nazionale dei Tumori 医学肿瘤学部收治的一系列连续MBC患者的临床数据进行了横断面分析，这些患者在接受全身疾病治疗后实现CR且至少随访2年。
在一个日历年中确定了76例实现CR的MBC患者。47例患者（61.8%）多次实现CR，共计123例。MBC诊断时的中位年龄为56岁（范围30 - 76岁）。52例患者（68.4%）为复发性疾病，24例（31.6%）为新发转移性疾病。大多数患者（80.3%）激素受体（HR）阳性，26例（34.2%）为HER2过表达的MBC。54例患者（71.1%）仅有一个转移部位。33例患者（43.4%）接受了局部治疗作为其治疗的一部分，67例（54.5%）在维持治疗期间实现CR。CR是持久的，中位随访8.3年（四分位间距5.8 - 11.0年）后，42例患者（55.3%）存活且无疾病证据。
单独全身治疗或全身与局部联合治疗后可出现持久的CR。大多数病例在疾病扩散有限的情况下出现CR，不一定是在一线治疗时。我们的研究强调了MBC多学科方法的关键作用以及维持治疗的益处。
