Dogan Izzet, Aksoy Sercan, Cakar Burcu, Basaran Gul, Ercelep Ozlem, Molinas Mandel Nil, Korkmaz Taner, Gokmen Erhan, Sener Cem, Aydiner Adnan, Saip Pinar, Eralp Yesim
Department of Medical Oncology, Institute of Oncology, Istanbul University, Istanbul 34093, Turkey.
Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara 06100, Turkey.
Cancers (Basel). 2023 Mar 8;15(6):1667. doi: 10.3390/cancers15061667.
This multicenter registry study aims to analyze time-related changes in the treatment patterns and outcome of patients with metastatic breast cancer (MBC) over a ten-year period. Correlations between demographic, prognostic variables and survival outcomes were carried out in database aggregates consisting of cohorts based on disease presentation (recurrent vs. de novo) and the diagnosis date of MBC (Cohort I: patient diagnosed between January 2010 and December 2014; and Cohort II: between January 2015 and December 2019). Out of 1382 patients analyzed, 52.3% patients had recurrent disease, with an increased frequency over time (47.9% in Cohort I vs. 56.1% in Cohort II, < 0.001). In recurrent patients, 38.4% ( = 277) relapsed within two years from initial diagnosis, among which triple-negative BC (TNBC) was the most frequent (51.7%). Median overall survival (OS) was 51.0 (48.0-55.0) months for all patients, which was similar across both cohorts. HER2+ subtype had the highest OS among subgroups (HER2+ vs. HR+ vs. TNBC; 57 vs. 52 vs. 27 months, < 0.001), and the dnMBC group showed a better outcome than recMBC (53 vs. 47 months, = 0.013). Despite the lack of CDK inhibitors, luminal A patients receiving endocrine therapy had a favorable outcome (70 months), constituting an appealing approach with limited resources. The only survival improvement during the timeframe was observed in HER2+ dnMBC patients (3-year OS Cohort I: 62% vs. Cohort II: 84.7%, = 0.009). The incorporation of targeted agents within standard treatment has improved the outcome in HER2+ MBC patients over time. Nevertheless, despite advances in early diagnosis and treatment, the prognosis of patients with TNBC remains poor, highlighting the need for more effective treatment options.
这项多中心注册研究旨在分析转移性乳腺癌(MBC)患者在十年期间治疗模式和结局的时间相关变化。在由基于疾病表现(复发与初发)和MBC诊断日期的队列组成的数据库汇总中,对人口统计学、预后变量与生存结局之间的相关性进行了分析(队列I:2010年1月至2014年12月期间诊断的患者;队列II:2015年1月至2019年12月期间诊断的患者)。在分析的1382例患者中,52.3%的患者患有复发性疾病,且随时间频率增加(队列I中为47.9%,队列II中为56.1%,P<0.001)。在复发性患者中,38.4%(n = 277)在初次诊断后两年内复发,其中三阴性乳腺癌(TNBC)最为常见(51.7%)。所有患者的中位总生存期(OS)为51.0(48.0 - 55.0)个月,两个队列相似。HER2+亚型在亚组中OS最高(HER2+ vs. HR+ vs. TNBC;57 vs. 52 vs. 27个月,P<0.001),初发MBC组的结局优于复发MBC组(53 vs. 47个月,P = 0.013)。尽管缺乏CDK抑制剂,但接受内分泌治疗的管腔A型患者结局良好(70个月),是资源有限情况下一种有吸引力的方法。在该时间段内,仅HER2+初发MBC患者的生存有改善(队列I的3年OS:62% vs. 队列II:84.7%,P = 0.009)。随着时间推移,在标准治疗中加入靶向药物改善了HER2+ MBC患者的结局。然而,尽管早期诊断和治疗取得了进展,但TNBC患者的预后仍然很差,凸显了需要更有效的治疗选择。