Dataset Information

First- and second-line treatment strategies for hormone-receptor (HR)-positive HER2-negative metastatic breast cancer: A real-world study.

ABSTRACT:

Background

Endocrine therapy (ET) plus cyclin-dependent-kinases 4/6 inhibitors (CDK4/6i) represents the standard treatment for luminal-metastatic breast cancer (MBC). However, prospective head-to-head comparisons are still lacking for 1st line (L) options, and it is still crucial to define the best strategy between 1st and 2nd L.

Materials and methods

717 consecutive luminal-MBC pts treated between 2008 and 2020 were analyzed at the Oncology Department of Aviano and Udine, Italy. Differences about survival outcomes (OS, PFS and PPS) were tested by log-rank test. The attrition rate (AR) between 1st and 2ndL was calculated.

Results

At 1^stL, pts were treated with ET (49%), chemotherapy (CT) (31%) and ET-CDKi (20%) while, at 2^ndL, 33% received ET, 33% CT and 8% ET-CDKi. Overall AR was 10%, 7% for CT, 8% for ET and 17% for ET-CDKi. By multivariate analysis, 1^stL ET-CDK4/6i showed a better mPFS1 and OS. Moreover, 2^ndL ET-CDK4/6i demonstrated better mPFS2 compared to ET and CT. Notably, 1^stL ET-CDKi resulted in higher mPFS than 2ndL ET-CDKi. Intriguingly, 1^stL ET-CDK4/6i was associated with worse mPPS compared to CT and ET. Secondarily, 1^stL ET-CDK4/6i followed by CT had worse OS compared to 1^stL ET-CDK4/6i followed by ET. Notably, none of baseline characteristics at 2^ndL influenced 2^ndL treatment choice (ET vs. CT) after ET-CDKi.

Conclusion

Our real-world data demonstrated that ET-CDKi represents the best option for 1^stL luminal-MBC compared to ET and CT. Also, the present study pointed out that 2^ndL ET, potentially combined with other molecules, could be a feasible option after CDK4/6i failure, postponing CT on later lines.

SUBMITTER: Basile D

PROVIDER: S-EPMC8053791 | biostudies-literature |

REPOSITORIES: biostudies-literature

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