Response to second‐line chemotherapy in patients with metastatic breast carcinoma previously responsive to first‐line treatment

Brun, Bernard; Benchalal, M.; Lebas, Christelle; Piedbois, Pascal; Ma, Lin; Lebourgeois, Jean‐Paul

doi:10.1002/(sici)1097-0142(19970601)79:11<2137::aid-cncr11>3.3.co;2-3

Cited by 2 publications

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“…Realworld studies indicate that response rates [11,13,[43][44][45][46][47][48][49][50] and TTP or treatment failure [11,[17][18][19][20][21][43][44][45][46][47][48]50,51] decline with subsequent chemotherapy lines. Additionally, response to and/or longer TTP or PFS of previous chemotherapy significantly influenced time to progression or PFS on next-line chemotherapy within multivariate analyses [12,17,18,45,47,[49][50][51][52]. In our current study, a TTP of >10 months in first-line was associated with better PFS in second-line study treatment (Table 2).…”

Section: Discussionmentioning

confidence: 57%

“…In comparison, trials reporting second-line PFS within this review were scarce, and medians varied from 2.5 to 9.8 months depending on the investigated single-agent [10]. Observational studies on multiple lines of chemotherapy for advanced breast cancer reported median second-line PFS or TTP between 2.5 and 11.7 months [11][12][13][14][15][16][17][18][19][20][21]. However, comparison of these outcomes between trials is limited due to the large variety in (amount of) previous treatments, selection of patients, type of chemotherapy and whether or not concurrent treatments were given.…”

Section: Discussionmentioning

confidence: 92%

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Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer

et al. 2020

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Background: Previously, we showed that reintroduction of the same (first-line) chemotherapy at progression could only partially make up for the loss in efficacy as compared to continuously delivered first-line chemotherapy. Here, we report the probability of starting second-line study chemotherapy in the Stop&Go trial, and the progression-free survival (PFS) and overall survival (OS) of patients who received both the first-and second-line treatment in an intermittent versus continuous schedule. Methods: First-line chemotherapy comprised paclitaxel plus bevacizumab, second-line capecitabine or non-pegylated liposomal doxorubicin, given per treatment line as two times four cycles (intermittent) or as eight consecutive cycles (continuous). Results: Of the 420 patients who started first-line treatment within the Stop&Go trial (210:210), a total of 270 patients continued on second-line study treatment (64% of all), which consisted of capecitabine in 201 patients and of non-pegylated liposomal doxorubicin in 69 patients, evenly distributed between the treatment arms. Median PFS was 3.7 versus 5.0 months (HR 1.07; 95% CI: 0.82-1.38) and median OS 10.9 versus 12.4 months (HR 1.27; 95% CI: 0.98-1.66) for intermittent versus continuous second-line chemotherapy. Second-line PFS was positively influenced by prior hormonal therapy for metastatic disease and longer first-line PFS duration, while triple-negative tumor status had a negative influence. Patients with a shorter time to progression (TTP) in first-line (10 months) had a higher probability of starting second-line treatment if they received intermittent compared to continuous chemotherapy (OR 1.97; 95% CI: 1.02-3.80). Conclusion: We recommend continuous scheduling of both the first-and second-line chemotherapy for advanced breast cancer.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 92%

Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer

et al. 2020

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“…En étude multifactorielle, l'intervalle libre prédit l'efficacité du traitement de rattrapage (22). Ici encore, la monochimiothé-rapie, notamment par taxane, devrait être envisagée en tenant compte de l'index thérapeutique (17,23).…”

Section: Traitements En Phase Palliative Activeunclassified

Soins palliatifs: peut-on parler de qualité de vie en phase métastatique?

Kerbrat

Botton

2007

Cancer Du Sein Avancé

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Poser la question sous cette forme paraît impliquer une réponse évidente. L'amélioration de la qualité de vie est un objectif premier de l'activité médi-cale, quelle qu'en soit sa situation : prévention, dépistage, thérapeutique adjuvante ou palliative ; le patient doit pouvoir espérer, sinon tirer, un bénéfice du geste entrepris. L'évaluation des avantages, quels qu'ils soient, doit être contrebalancée par celle des inconvénients.En situation métastatique d'un cancer du sein, cette question peut paraître curieuse dans la mesure où, sauf cas exceptionnel, la patiente ne peut espérer guérir, avec une survie en moyenne inférieure à 3 ans, même si 10 % des malades peuvent espérer une survie supérieure à 10 ans (1). Durant cette période, plusieurs traitements spécifiques, systémiques -chimiothérapie, hormonothérapie, et traitements ciblés -ou locorégionaux -chirurgie, radiothérapie, radiologie interventionnelle -, mais aussi non spécifiques -bisphosphonates, antalgiques, corticoïdes, etc. -seront utilisés.À chaque instant le thérapeute devra, pour la patiente et avec elle, évaluer le rapport coût/bénéfice. Après une réflexion sur les objectifs du traitement, et la définition et la mesure de la qualité de vie, nous séparerons artificiellement deux phases durant cette période, de longueur très variable, une phase « palliative active » où une thérapeutique anticancéreuse sera employée, puis une phase « palliative terminale » proprement dite, avec parfois une frontière difficile à définir ( fig. 1) (2). Objectifs des traitementsIls ont été encore récemment définis en rappelant qu'actuellement le cancer du sein métastatique reste une maladie incurable. Pour le groupe allemand

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Response to second‐line chemotherapy in patients with metastatic breast carcinoma previously responsive to first‐line treatment

Cited by 2 publications

References 0 publications

Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer

Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer

Soins palliatifs: peut-on parler de qualité de vie en phase métastatique?

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