Cazzaniga Marina, Verusio Claudio, Ciccarese Mariangela, Fumagalli Alberto, Sartori Donata, Valerio Maria Rosario, Ancona Cristina, Airoldi Mario, Moretti Gabriella, Ficorella Corrado, Arcangeli Valentina, Diodati Lucrezia, Zambelli Alberto, Febbraro Antonio, Generali Daniele, Pistelli Mirco, Garrone Ornella, Musolino Antonino, Vici Patrizia, Maur Michela, Mentuccia Lucia, La Verde Nicla, Bianchi Giulia, Artale Salvatore, Blasi Livio, Piezzo Matilde, Atzori Francesco, Turletti Anna, Benedetto Chiara, Cursano Maria Concetta, Fabi Alessandra, Gebbia Vittorio, Schirone Antonio, Palumbo Raffaella, Ferzi Antonella, Frassoldati Antonio, Scavelli Claudio, Clivio Luca, Torri On Behalf Of The Eva Study Group Valter
Research Unit Phase I trials, ASST Monza, Monza, Italy.
Oncology Unit, ASST Monza, Monza, Italy.
Oncotarget. 2018 Aug 7;9(61):31877-31887. doi: 10.18632/oncotarget.25874.
The present analysis focuses on real-world data of Everolimus-Exemestane in advanced HR+ve, HER2-ve elderly breast cancer patients (aged 65 years) included in the EVA study, with unique findings in those aged 70 years.
Data are collected from clinical records and analysed according to age cut-off (< 65 years; 65 - 69 years and {greater than or equal to} 70 years). Relationship of analyzed variables with response were tested by mean of a Mantel-Haenszel chi square test. Time to event analysis was described by Kaplan Meier approach and association with baseline characteristics was analysed by stratified log-rank test and proportional hazard model.
From July 2013 to December 2015, the EVA study enrolled overall 404 pts. 154 patients out of 404 (38,1%) were aged {greater than or equal to} 65 years, of whom 87 were {greater than or equal to} 70 years. Median duration of EVE treatment was 28.5 weeks (95% CI 19.0 - 33.8) in patients aged 65-69 years and 24,4 weeks (95% CI 19,2 - 33,2) in those aged {greater than or equal to} 70 years. Fewer patients aged 65 years received the highest EVE Dose-Intensity (>7.5 mg/day) in comparison to younger patients (49,6% vs. 66,8%). Grade 3-4 toxicities occurred to 55 patients (35,7%), mainly stomatitis (10,9%), rash (5,8%) and non-infectious pneumonitis (NIP) (3,6%). Some toxicities, such as weight loss and anaemia were peculiarly observed in patients aged {greater than or equal to} 70 years. Five treatment-related deaths were collected (3,2%).
EVE-EXE combination remains one of the potential treatments in HR+ patients also for elderly ones.
本分析聚焦于依维莫司 - 依西美坦在EVA研究纳入的晚期HR + 、HER2 - 老年乳腺癌患者(年龄≥65岁)中的真实世界数据,在70岁患者中有独特发现。
从临床记录中收集数据,并根据年龄界限(<65岁;65 - 69岁和≥70岁)进行分析。通过Mantel - Haenszel卡方检验来检验分析变量与反应之间的关系。采用Kaplan Meier方法描述事件发生时间分析,并通过分层对数秩检验和比例风险模型分析与基线特征的关联。
2013年7月至2015年12月,EVA研究共纳入404例患者。404例中有154例患者(38.1%)年龄≥65岁,其中87例年龄≥70岁。65 - 69岁患者中依维莫司治疗的中位持续时间为28.5周(95%CI 19.0 - 33.8),≥70岁患者中为24.4周(95%CI 19.2 - 33.2)。与年轻患者相比,65岁及以上患者接受最高依维莫司剂量强度(>7.5mg/天)的人数较少(49.6%对66.8%)。55例患者(35.7%)发生3 - 4级毒性反应,主要为口腔炎(10.9%)、皮疹(5.8%)和非感染性肺炎(NIP)(3.6%)。一些毒性反应,如体重减轻和贫血,在≥70岁患者中尤为常见。收集到5例与治疗相关的死亡病例(3.2%)。
依维莫司 - 依西美坦联合方案仍是HR + 患者(包括老年患者)的潜在治疗方案之一。