Matteo Lambertini1, Arlindo R Ferreira2, Antonio Di Meglio3, Francesca Poggio4, Fabio Puglisi5, Federico Sottotetti6, Filippo Montemurro7, Elena Poletto5, Antonio Bernardo6, Emanuela Risi8, Chiara Dellepiane9, Valentina Sini10, Gabriele Minuti11, Donatella Grasso12, Sara Fancelli13, Lucia Del Mastro9. 1. Breast Cancer Translational Research Laboratory, Institut Jules Bordet, and l'Université Libre de Bruxelles, Brussels, Belgium; Department of Medicine, BrEAST Data Center, Institut Jules Bordet, and l'Université Libre de Bruxelles, Brussels, Belgium. Electronic address: matteo.lambertini85@gmail.com. 2. Department of Medical Oncology, Hospital de Santa Maria and Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal. 3. Department of Medical Oncology, Clinica di Oncologia Medica, IRCCS AOU San Martino-IST, Genova, Italy. 4. Department of Medical Oncology, U.O. Oncologia Medica 2, IRCCS AOU San Martino-IST, Genova, Italy. 5. Department of Medical and Biological Sciences, University of Udine, Udine, Italy. 6. Medical Oncology, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy. 7. Investigative Clinical Oncology (INCO), Fondazione del Piemonte per L'Oncologia, Candiolo Cancer Center (IRCCS), Candiolo, Italy. 8. Sandro Pitigliani Medical Oncology Department, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy. 9. Department of Medical Oncology, U.O. Sviluppo Terapie Innovative, IRCCS AOU San Martino-IST, Genova, Italy. 10. Oncology Unit, Sant'Andrea Hospital, Sapienza University of Rome, and Oncology Unit ASL Roma 1 Santo Spirito Hospital, Rome, Italy. 11. Department of Medical Oncology, Santa Maria delle Croci Hospital, Ravenna, Italy. 12. Medical Oncology, IRCCS San Matteo University Hospital Foundation, Pavia, Italy. 13. UO Oncologia 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy.
Abstract
BACKGROUND: The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. PATIENTS AND METHODS: This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. RESULTS: From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2%) presented with de novo MBC and 303 (72.8%) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95% confidence interval [CI], 0.43-0.97; P = .035) and for overall survival (OS) of 0.53 (95% CI, 0.30-0.95; P = .034). In the de novo cohort, the 54 patients (47.8%) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95% CI, 0.26-0.72; P = .001) and OS (adjusted HR, 0.49; 95% CI, 0.26-0.93; P = .029) than those who did not undergo surgery. CONCLUSION: Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.
BACKGROUND: The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. PATIENTS AND METHODS: This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. RESULTS: From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2%) presented with de novo MBC and 303 (72.8%) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95% confidence interval [CI], 0.43-0.97; P = .035) and for overall survival (OS) of 0.53 (95% CI, 0.30-0.95; P = .034). In the de novo cohort, the 54 patients (47.8%) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95% CI, 0.26-0.72; P = .001) and OS (adjusted HR, 0.49; 95% CI, 0.26-0.93; P = .029) than those who did not undergo surgery. CONCLUSION:Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.
Authors: Barbara A Conley; Lou Staudt; Naoko Takebe; David A Wheeler; Linghua Wang; Maria F Cardenas; Viktoriya Korchina; Jean Claude Zenklusen; Lisa M McShane; James V Tricoli; Paul M Williams; Irina Lubensky; Geraldine O'Sullivan-Coyne; Elise Kohn; Richard F Little; Jeffrey White; Shakun Malik; Lyndsay N Harris; Bhupinder Mann; Carol Weil; Roy Tarnuzzer; Chris Karlovich; Brian Rodgers; Lalitha Shankar; Paula M Jacobs; Tracy Nolan; Sean M Berryman; Julie Gastier-Foster; Jay Bowen; Kristen Leraas; Hui Shen; Peter W Laird; Manel Esteller; Vincent Miller; Adrienne Johnson; Elijah F Edmondson; Thomas J Giordano; Benjamin Kim; S Percy Ivy Journal: J Natl Cancer Inst Date: 2021-01-04 Impact factor: 11.816