The impact of new chemotherapeutic and hormone agents on survival in a population‐based cohort of women with metastatic breast cancer

Abstract

BACKGROUND. Over the past decade, a number of new therapeutic agents have become available in the treatment of metastatic breast cancer (MBC). This study characterized the use and assessed the impact on survival of population‐based access to new agents for the treatment of MBC. METHODS. The dates of release in British Columbia of 7 new systemic agents for MBC during the 1990s were used to construct 4 time cohorts. All patients with a first diagnosis of distant metastases in each of the time cohorts were identified and characterized, and their survival was compared. Cox proportional regression modeling was used to assess for predictors of survival. RESULTS. In total, 2150 patients with a first distant metastases diagnosed during 1 of the 4 cohort intervals were identified. Baseline characteristics between cohorts were similar, except a greater proportion of the later cohorts received adjuvant chemotherapy (P < .001), had positive estrogen receptor status (P = .01), and had a longer median time from initial diagnosis to MBC (P < .001). Survival in Cohort 1 (1991–1992) and Cohort 2 (1994–1995; median, 438 days and 450 days, respectively) was similar. Survival was longer in Cohort 3 (1997–1998; median, 564 days; P = .002) and improved further in Cohort 4 (1999–2001; median, 667 days; P = .05). In multivariate analysis, the later cohorts were associated independently with improved survival (P = .01 and P < .001, respectively). CONCLUSIONS. Population‐based access to new therapeutic agents for MBC appeared to be associated with improved survival. To the authors' knowledge, this is the first study to date that demonstrates, from a population‐based perspective, improving survival over the past decade for women with MBC. Cancer 2007. © 2007 American Cancer Society.

Improved survival of patients with primary distant metastatic breast cancer in the period of 1995–2008. A nationwide population-based study in the Netherlands

“…Our study is covering a relatively short period, which makes it less likely that changes in radiologic facilities (except perhaps for the introduction of positron emission tomography) have had a large impact on the detection of metastatic disease. Moreover, the percentage of patients with metastatic disease has remained rather stable during the different time periods, also indicating that screening methods and indications In conclusion, an overall improvement of 6 months is observed between 15 breast cancer, resulting in a median survival of almost 2 years for the patients treated in the last period. This improvement was most pronounced in patients younger than 50 years.…”

“…In a populationbased study by Rapiti et al, based on 300 patients diagnosed between 1977 and 1996 and documented by the Geneva Cancer Registry, an improvement of the breast cancer-specific survival was demonstrated in the unadjusted but not in the adjusted multivariable analysis [7]. In a previous population-based study, Most studies on trends in prognosis of patients with primary metastatic breast cancer are hospital-based [13], or also included patients with secondary metastatic disease or patients participating in randomized clinical trials comparing different lines of chemotherapy [14][15][16][17]. The interval between the primary tumor and the diagnosis of metastatic disease is an important prognostic factor.…”

Fifteen-year trends in metastatic breast cancer survival in Greece

“…In this study, although this temporal improvement in survival is attributed to ''new chemotherapeutic and hormone agents'' for MBC, no attempt is made to include these agents as predictors in the multivariate Cox models that include the time cohorts. Thus, this study also can be considered at best a surrogate to suggest that systemic therapy is associated with improved survival [23].…”

Role of Nek2 on centrosome duplication and aneuploidy in breast cancer cells

“…Such therapies, which include taxanes, aromatase inhibitors, and trastuzumab (2,3), have significantly improved outcomes for patients with breast cancers of the luminal or HER2 subtypes. Sadly, an effective targeted treatment is still lacking for patients whose tumors are of the highly aggressive triple negative breast cancer (TNBC) subtype (4,5).…”