A recent study sheds light on factors influencing survival outcomes in women with hormone receptor-positive, ERBB2-negative metastatic breast cancer. The study, which analyzed data from 506 women, offers valuable insights into the impact of various treatment strategies on progression-free survival (PFS) and overall survival.
The median age of participants at diagnosis was 52.4 years. Researchers focused on patients who experienced disease progression during first- or second-line endocrine therapy combined with CDK4/6 inhibitor treatment. Notably, those who received a second CDK4/6 inhibitor therapy after initial tumor progression were excluded from the study. Findings revealed that longer durations of CDK4/6 inhibitor therapy correlated with improved overall survival outcomes.
Impact of Metastases and Treatment Choices
The presence of visceral metastases significantly influenced survival rates, with these patients exhibiting poorer overall survival. Interestingly, the study highlighted a stark difference in the effectiveness of chemotherapy routes for these patients.
“In this cohort study of 506 patients diagnosed with hormone receptor-positive, ERBB2-negative metastatic breast cancer progressing during endocrine therapy plus CDK4/6 inhibitor treatment, our findings suggest that oral chemotherapy could be a preferred option for select patients with visceral metastases, offering comparable survival outcomes with potentially fewer adverse effects and greater convenience,” the authors stated.
Among patients with visceral metastases, intravenous chemotherapy was associated with shorter overall survival compared to oral chemotherapy. This distinction underscores the potential benefits of choosing oral over intravenous chemotherapy in certain cases.
Progression and Treatment Patterns
The majority of patients, 67.6%, received a combination of endocrine therapy and CDK4/6 inhibitors as a first-line treatment, while 32.4% began this regimen as a second-line treatment. Following disease progression, 221 patients transitioned to endocrine therapy, whereas 285 received chemotherapy.
Comparative analysis between treatment modalities showed that intravenous chemotherapy and endocrine therapy were linked to shorter PFS compared to oral chemotherapy. However, no significant differences in overall survival were observed among these treatments. Older age was associated with slightly improved PFS, suggesting age-related factors may play a role in disease progression dynamics.
Key Endpoints and Risk Factors
The study identified two primary endpoints: progression-free survival and overall survival. PFS was defined as the time from initiating the first systemic treatment to the detection of disease progression or any-cause death. Overall survival measured the interval between tumor progression during combination therapy and any-cause death.
Crucially, the study pinpointed key risk factors associated with disease progression or death. The presence of visceral metastases and de novo metastatic disease emerged as independent predictors of higher progression or mortality risk. These findings underscore the importance of tailoring treatment strategies to individual patient profiles.
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