Everolimus Plus Hormonotherapy (Ht) Induces Survival Gain in Late Metastatic Breast Cancer (Mbc) After Progression: Could this Line Be Better Than a Late New Chemotherapy (Ct) Line?

Everolimus-Based Therapy versus Chemotherapy among Patients with HR+/HER2− Metastatic Breast Cancer: Comparative Effectiveness from a Chart Review Study

“…The present comparative effectiveness findings are consistent with recent studies showing that HR+/HER2− mBC patients treated with everolimus-based therapy tended to have better OS [ 17 , 18 ] and PFS [ 19 ] than those treated with chemotherapy. For example, using a small sample of HR+/HER2− mBC patients, Pouget et al showed that everolimus plus endocrine therapy resulted in significantly longer OS than chemotherapy for patients pretreated with two or fewer lines of therapies for mBC [ 17 , 18 ].…”

“…The present comparative effectiveness findings are consistent with recent studies showing that HR+/HER2− mBC patients treated with everolimus-based therapy tended to have better OS [ 17 , 18 ] and PFS [ 19 ] than those treated with chemotherapy. For example, using a small sample of HR+/HER2− mBC patients, Pouget et al showed that everolimus plus endocrine therapy resulted in significantly longer OS than chemotherapy for patients pretreated with two or fewer lines of therapies for mBC [ 17 , 18 ]. Cope et al (2013) conducted a network meta-analysis of available mBC clinical trials and concluded that despite differences in patient characteristics across studies, everolimus/exemestane combinational therapy was associated with the longer mean PFS until 20 months compared to commonly-used chemotherapies such as capecitabine, doxorubicin, paclitaxel, and vinorelbine [ 19 ].…”

“…The current NCCN guidelines recognize this and support subsequent treatment to prolong the benefits of endocrine therapies for as long as possible before initiating chemotherapy [ 8 ]. Together with recent studies [ 17 , 18 ], the current findings suggest that everolimus-based therapy may be a more effective alternative to chemotherapy after initial failure of nonsteroidal AIs. Furthermore, previous studies have shown that while everolimus may result in some moderate toxicity [ 23 , 24 ], the adverse events are generally manageable [ 25 ] and the patient's health-related QOL is similar to that of patients on endocrine therapy [ 26 ].…”

“…Currently, there is limited evidence regarding the comparative effectiveness of everolimus-based therapy and chemotherapy, two common treatment options for HR+/HER2− mBC after initial failure of nonsteroidal AI. Several recent studies presented in oncology conferences have indicated that everolimus/exemestane combinational therapy was associated with significantly longer survival compared to chemotherapies [ 17 , 18 ], but these studies were based on small samples of patients [ 17 ] or physician surveys [ 18 ]. A network meta-analysis of previous mBC trials also found that everolimus/exemestane combinational therapy was associated with comparable or better PFS compared to some commonly-used chemotherapy; however, findings in clinical trial settings may not represent the real-world comparative effectiveness.…”