RTI Health Solutions, Research Triangle Park, NC.
Pfizer Inc, New York, NY.
Clin Breast Cancer. 2018 Aug;18(4):e529-e538. doi: 10.1016/j.clbc.2017.10.008. Epub 2017 Oct 14.
To describe treatment patterns and clinical outcomes among postmenopausal women with metastatic ER/HER-2 breast cancer treated with ≥ 2 lines of endocrine therapy or chemotherapy in the metastatic setting.
Retrospective medical record review was conducted in Canada, the United Kingdom, Belgium, the Netherlands, Germany, Spain, and France. Baseline characteristics were assessed at the date of metastatic diagnosis. Time to progression (TTP) and overall survival (OS) were estimated by Kaplan-Meier analyses. Multivariable models were used to evaluate factors associated with disease progression.
Among 901 patients, the mean (standard deviation) age at metastatic diagnosis was 62.7 (9.7) years; 67.26% were initially diagnosed with metastatic disease, 66.37% had visceral disease, and 25.86% had bone metastasis only. Two-thirds of patients received endocrine therapy for first-line treatment. Fifty-nine percent received endocrine therapy, and 37.18% received chemotherapy for second-line treatment. The most common reason for stopping treatment was disease progression. Median (95% confidence interval [CI]) TTP on first-line endocrine treatment was 11.3 (10.7-12.2) months and 7.0 (6.3-7.9) months on chemotherapy. Median (95% CI) TTP on second-line endocrine therapy was 8.1 (7.5-9.1) months and 6.1 (5.4-6.8) months on chemotherapy. Median (95% CI) OS was 68.6 (52.2-83.7) months after first-line endocrine therapy and 39.7 (34.5-48.7) months after chemotherapy.
Patients prescribed endocrine therapy had longer TTP and OS than patients prescribed chemotherapy in the first- and second-line settings. Disease progression was less than a year regardless of treatment type and line of therapy, indicating a need for treatments that delay progression without affecting quality of life among these patients.
描述在转移性环境中接受≥2 线内分泌治疗或化疗的绝经后 ER/HER-2 阳性转移性乳腺癌女性的治疗模式和临床结局。
在加拿大、英国、比利时、荷兰、德国、西班牙和法国进行了回顾性病历审查。在转移性诊断日期评估了基线特征。通过 Kaplan-Meier 分析估计无进展生存期 (TTP) 和总生存期 (OS)。使用多变量模型评估与疾病进展相关的因素。
在 901 名患者中，转移性诊断时的平均（标准差）年龄为 62.7（9.7）岁；67.26%的患者最初被诊断为转移性疾病，66.37%的患者有内脏疾病，25.86%的患者仅有骨转移。三分之二的患者接受内分泌治疗作为一线治疗。59%的患者接受内分泌治疗，37.18%的患者接受化疗作为二线治疗。停止治疗的最常见原因是疾病进展。一线内分泌治疗中位（95%置信区间 [CI]）TTP 为 11.3（10.7-12.2）个月，化疗中位（95%CI）TTP 为 7.0（6.3-7.9）个月。二线内分泌治疗中位（95%CI）TTP 为 8.1（7.5-9.1）个月，化疗中位（95%CI）TTP 为 6.1（5.4-6.8）个月。一线内分泌治疗后中位（95%CI）OS 为 68.6（52.2-83.7）个月，化疗后中位（95%CI）OS 为 39.7（34.5-48.7）个月。
在一线和二线治疗中，接受内分泌治疗的患者 TTP 和 OS 长于接受化疗的患者。无论治疗类型和治疗线数如何，疾病进展均不到 1 年，这表明需要使用不会影响这些患者生活质量的治疗方法来延缓进展。
