This section focuses on different aspects of the individualization of hormone treatment in breast cancer. This includes tumor-related biological factors such as expression of hormone receptors, HER-2, and Ki-67; host-related factors such as CYP2D6 or body mass index, and risk and/or development of specific toxicities and treatment adherence. The best predictor of response to hormonal interventions is the expression of hormone receptors, in particular, estrogen receptors. Treatment adherence and compliance are key factors and strategies aiming to identify and intervene when patients are at risk of abandoning treatment. Currently, routine assessment of CYP2D6 is not recommended to guide tamoxifen treatment. Likewise, there are no criteria regarding bone mass density, lipid profile, or arthralgias to recommend one class of agent versus another. Aromatase inhibitors should not be administered to patients who are pre- or perimenopausal.
visceral disease and 89% had non visceral disease. ERI was received in 2 nd , 3rd and 4th line of metastatic treatment for respectively 21%, 44% and 35% pts. Complete response (CR), partial response (PR) and stable disease (SD) were observed respectively for 2.4%, 46.4% and 51.2% of pts.The median duration of response was 25.6 weeks (95 IC 22-27.7) with a median number of infusions of 6. Response was similar irrespective of ERI line number. HD was observed in 70.2% of pts with 3.4% of CR, 50.8% of PR and 45.8% of SD. The median PFS was 9 mo. (95 %CI 8-10). Subgroup analysis showed similar PFS irrespective of HD (p¼0.21) and treatment line (p¼0.46). The median OS was 24 mo. (95% IC 20-31). Predictive factors of PFS in univariate analysis were progesterone receptor expression (p¼0.014), number of ERI infusions (p¼0.011) and duration of response (p<0.001); in multivariate analysis the main predictive factor was duration of response (p¼0.003). The same predictive factors were found for pts with HD.Conclusions: Response to ERI and PFS were independent of presence of hepatic metastasis and number of line by ERI. The duration of response, number of line by ERI and positive progesterone receptor are the main predictive factors of PFS in our cohort and in pts with HD.Clinical trial identification: NCT03771183.
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