Department of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, Germany.
Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen-EMN, Friedrich Alexander University of Erlangen-Nuremberg, Germany.
Eur J Cancer. 2022 Sep;172:13-21. doi: 10.1016/j.ejca.2022.05.015. Epub 2022 Jun 18.
Patients with de novo metastatic breast cancer (dnMBC) may have different clinical and pathological characteristics. In studies concerned with first-line metastatic patients, the proportion of these patients without secondary resistance mechanisms may have a large influence ont the study results. The aim of this study was to identify patient and tumor characteristics that are associated with dnMBC vs. recurrent MBC (rMBC).
This is a retrospective analysis of data prospectively collected in the PRAEGNANT metastatic breast cancer registry (NCT02338167). Firs line treated patients were eligible. Patient and tumor characteristics were compared with common disease and tumor characteristics relative to de novo metastatic status, as well as early and late recurrences after primary disease without metastases.
Among the 947 patients identified, 355 were included with de novo metastatic disease (37.5%). Older age and HER2-positive disease were significantly associated with a higher frequency of dnMBC. Patients younger than 50, 50-69, or 70 years or older had dnMBC frequencies of 22.7%, 44.0%, and 57.6%, respectively. HER2-positive patients had dnMBC at initial presentation in 49.1% of cases, in comparison with 21.9%, 35.5%, and 37.6% in patients with triple-negative, luminal A-like and luminal B-like breast cancer, respectively.
Age and breast cancer subtype are associated with the frequency of first-line MBC patients. Inclusion criteria concerning age or breast cancer subtype can influence the frequency of these patients in a selected patient population and can therefore modify the number of patients with secondary resistance to specific therapies in clinical trials.
初诊转移性乳腺癌（dnMBC）患者可能具有不同的临床和病理特征。在针对一线转移性患者的研究中，无继发性耐药机制的患者比例可能对研究结果产生重大影响。本研究旨在确定与 dnMBC 与复发性 MBC（rMBC）相关的患者和肿瘤特征。
这是对前瞻性收集的 PRAEGNANT 转移性乳腺癌登记处（NCT02338167）数据进行的回顾性分析。符合条件的患者为一线治疗的患者。比较了患者和肿瘤特征与初诊转移性状态以及原发性疾病无转移后早期和晚期复发的常见疾病和肿瘤特征。
在确定的 947 例患者中，355 例患有初诊转移性疾病（37.5%）。年龄较大和 HER2 阳性疾病与 dnMBC 发生率显著相关。年龄小于 50 岁、50-69 岁或 70 岁以上的患者发生 dnMBC 的频率分别为 22.7%、44.0%和 57.6%。HER2 阳性患者初诊时 dnMBC 的发生率为 49.1%，而三阴性、luminal A 样和 luminal B 样乳腺癌患者分别为 21.9%、35.5%和 37.6%。
年龄和乳腺癌亚型与一线 MBC 患者的频率相关。纳入年龄或乳腺癌亚型的标准可能会影响选定患者人群中这些患者的频率，并因此改变临床试验中特定治疗方法继发性耐药的患者数量。
