Significant survival improvement of patients with recurrent breast cancer in the periods 2001-2008 vs. 1992-2000

Abstract

BackgroundIt is unclear whether individualized treatments based on biological factors have improved the prognosis of recurrent breast cancer. The purpose of this study is to evaluate the survival improvement of patients with recurrent breast cancer after the introduction of third generation aromatase inhibitors (AIs) and trastuzumab.MethodsA total of 407 patients who received first diagnosis of recurrent breast cancer and treatment at National Kyushu Cancer Center between 1992 and 2008 were retrospectively evaluated. As AIs and trastuzumab were approved for clinical use in Japan in 2001, the patients were divided into two time cohorts depending on whether the cancer recurred before or after 2001. Cohort A: 170 patients who were diagnosed between 1992 and 2000. Cohort B: 237 patients who were diagnosed between 2001 and 2008. Tumor characteristics, treatments, and outcome were compared.ResultsFourteen percent of cohort A and 76% of cohort B received AIs and/or trastuzumab (P < 0.001). The median overall survival (OS) times after breast cancer recurrence were 1.7 years and 4.2 years for these respective cohorts (P < 0.001). Both the time period and treatment of AIs and/or trastuzumab for recurrent disease were significant prognostic factors in multivariate analysis (cohort B vs. cohort A: HR = 0.70, P = 0.01; AIs and/or trastuzumab for recurrent disease: yes vs. no: HR = 0.46, P < 0.001). When patients were categorized into 4 subgroups by the expression of hormone receptor (HR) and HER-2 status, the median OS times of the HR-positive/HER-2-negative, HR-positive/HER-2-positive, HR-negative/HER-2-positive, and HR-negative/HER-2-negative subtypes were 2.2, 2.4, 1.6, and 1.0 years in cohort A and 4.5, 5.1, 5.0, and 1.4 years in cohort B.ConclusionsThe prognosis of patients with recurrent breast cancer was improved over time following the introduction of AIs and trastuzumab and the survival improvement was apparent in HR- and/or HER-2-positive tumors.

Survival times of women with metastatic breast cancer starting first‐line chemotherapy in routine clinical practice versus contemporary randomised trials

“…Patients with HER2‐positive tumours lived significantly longer than those with HER2‐negative tumours reflecting their favourable response to HER2‐directed therapy with trastuzumab and lapatinib, similar to the findings from our systematic review and other studies . The other independent predictors of survival, hormone receptor status, ECOG performance status and receipt of adjuvant chemotherapy were as expected.…”

Temporal trends in the surgical outcomes of patients with breast cancer

“…In recent years, anthracycline-based chemotherapy was followed by taxanes when the risk of relapse was high. Furthermore, trastuzumab, which acts on HER2 receptors, has markedly improved the prognosis of patients with HER2-positive breast cancer, further changing drug therapy regimes for breast cancer [16]. We started to use trastuzumab for patients with HER2-positive breast cancer form the early 2000s.…”

Living with limited time: Socioemotional selectivity theory in the context of health adversity.

“…To address this question in a naturalistic setting, we compared both self-reported life goals and preferences in attention and memory for emotional stimuli between two groups of similarly aged women who faced life circumstances that theoretically should engender differences in the length of time they perceive likely remains in life, or time perspective. Metastatic breast cancer typically is life-limiting; currently, 24% of women first diagnosed with metastatic (Stage IV) breast cancer are expected to live for at least five years, with a somewhat lower survival rate for recurrent disease (American Cancer Society, 2013; Dawood et al, 2011). Because women with metastatic breast cancer theoretically are living under conditions of more limited time perspective than their similarly aged peers, we sought to investigate whether preferences in attention, memory, and life goals align with this incongruity.…”