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

Thientosapol, Eddy Sanchai; Tran, Thao; Della-Fiorentina, Stephen; Adams, Diana; Chantrill, Lorraine A.; Stockler, Martin R.; Kiely, Belinda E

doi:10.1111/imj.12178

Cited by 14 publications

(13 citation statements)

References 19 publications

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“…From the patient's perspective, this uncertainty is psychologically distressing. [10][11][12] Studies suggest that a lack of insight into disease status and prognosis can lead to poorer outcomes among patients with advanced or incurable cancer, with psychological consequences including increased mistrust and feelings of abandonment. 12,13 Furthermore, the cancer-free implication of an NED status is clearly a strongly desired outcome for any patient with MBC, and validation of the frequency with which this status occurs is influential.…”

Section: Introductionmentioning

confidence: 99%

Prognosis for patients with metastatic breast cancer who achieve a no‐evidence‐of‐disease status after systemic or local therapy

Bishop

Ensor

Moulder

et al. 2015

Cancer

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Purpose We sought to determine outcomes for patients with metastatic breast cancer (MBC) with no evidence of disease (NED) after treatment and to identify factors predictive of outcome once NED status was attained. Methods We reviewed 570 patients with MBC consecutively treated between January 2003 through December 2005. Ninety patients (16%) attained NED, as defined by a complete metabolic response by positron emission tomography or sclerotic healing of bone metastases on computed tomography or magnetic resonance imaging. Median follow-up for patients attaining NED was 100 months (range, 14–134 months). Results The 3- and 5-year overall survival (OS) rates for the entire group were 44% and 24%, respectively, compared to 96% and 78% for those attaining NED. Using a landmark analysis, NED status was significantly associated with survival at 2 years (P<0.001, HR 0.23, 95% CI 0.16-0.34) and 3 years (P<0.001, HR 0.20, 95% CI 0.14-0.30). From the time of NED, the median survival was 102 months (range, 14-134) with a 5-year OS and progression free survival (PFS) of 77% and 40%, respectively. On multivariate analysis, HER2+ was significantly associated with OS (vs. ER+, P=0.02, HR 0.44, 95% CI 0.21-0.90), and trastuzumab use was significantly associated with PFS (P=0.007, HR 0.48, 95% CI 0.28-0.82). Thirty-one patients (34%) with NED remained in remission at last follow-up. Conclusions MBC patients who attain NED status have a significantly prolonged survival with a durable response to therapy. Ultimately, this study provides essential outcomes data for clinicians and patients living with MBC.

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Section: Introductionmentioning

confidence: 99%

Prognosis for patients with metastatic breast cancer who achieve a no‐evidence‐of‐disease status after systemic or local therapy

Bishop

Ensor

Moulder

et al. 2015

Cancer

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“…Agarwal et al reported an 81.8 months median overall survival for TNBC patients [11]. The overall survival of a metastatic TNBC patient is 18 months from the diagnosis of the metastasis [4,12,13]. Our patient lived 89 months after her first diagnosis of TNBC (25 months with stage IV disease).…”

Section: Discussionmentioning

confidence: 67%

Sterile, abscess-like cerebral lesion during trastuzumab therapy after HER2 status switch in a triple negative breast cancer patient: a case report and literature review

et al. 2020

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Background: Breast cancer is a global health problemit is the most common malignancy among women. Triple negative breast cancers (TNBC) account for 10-20% of female breast cancer. Most TNBC cases confer poor prognosis. Brain metastasis appears in more than 15% in the triple negative breast cancer population, which causes serious decrease in survival. Changes of immunophenotype are not uncommon in breast cancer, offering new therapeutic options in cases where targetable proteins or pathways are being identified. Case presentation: After five lines of chemotherapy and 82 months following the first diagnosis, our patient with brain metastatic triple negative breast cancer had human epidermal growth factor receptor 2 (HER2) genetic heterogeneity in the metastatic tissue sample interpreted as HER2 status conversion. After the removal of the metastasis, we started first line therapy for metastatic HER2 positive cancer with trastuzumab and paclitaxel. After the first cycle of trastuzumab, on day 8, she had a seizure, and neurosurgical examination showed an abscess-like lesion. The punctate proved to be sterile by microbiological and pathological examination, so we continued cytostatic therapy without the anti-HER2 antibody. 3 months later, we could not identify the previous abscess-like lesion in the control computer tomography (CT) scan, and our patient had no neurological deficits. Conclusion: We emphasize the importance of regular tissue confirmation of predictive markers in progressive tumorous disease even if our presented case is not unequivocally a "conversion case". Tumor subtype is determined according to algorithms and definitions published in guidelines, nevertheless, use of different guidelines may lead to controversial interpretation in cases where HER2 genetic heterogeneity is present. Furthermore, we suggest that seronegative, aseptic intracranial fluid effusion after the removal of a brain metastasis may possibly be a side effect of trastuzumab.

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“…In a single institution study of 2091 mBC patients, Dawood et al 17 reported a 44% decreased risk of death among patients with HER2/neupositive disease treated with trastuzumab as first-line therapy compared to HER2/neu-negative patients. Similarly, in a separate study of mBC patients initiating first-line chemotherapy at a single oncology clinic, Thientosapol and colleagues found that mBC patients with HER2þ tumors lived significantly longer than patients with HER2-negative tumors (HR ¼ 0.49, CI 0.34-0.72, p50.001), reflecting positive responses to HER2-targeted agents 18 . A potential reason for this discrepancy is that the study populations were defined differently.…”

Section: Discussionmentioning

confidence: 93%

Treatment patterns and survival in metastatic breast cancer patients by tumor characteristics

Hao

Meyer

Song

et al. 2015

Current Medical Research and Opinion

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

Cited by 14 publications

References 19 publications

Prognosis for patients with metastatic breast cancer who achieve a no‐evidence‐of‐disease status after systemic or local therapy

Prognosis for patients with metastatic breast cancer who achieve a no‐evidence‐of‐disease status after systemic or local therapy

Sterile, abscess-like cerebral lesion during trastuzumab therapy after HER2 status switch in a triple negative breast cancer patient: a case report and literature review

Treatment patterns and survival in metastatic breast cancer patients by tumor characteristics

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