Treatment and outcomes of older versus younger women with HER2-positive metastatic breast cancer in the real-world national ESME database.

Autor: Annonay M; Department of Medical Oncology, Institut Bergonié, Bordeaux, France., Gauquelin L; Clinical and Epidemiological Research Unit, Institut Bergonié, Bordeaux, France; Epicene Team (Cancer & Environnement), Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France., Geiss R; Department of Medical Oncology, Institut Curie, Saint-Cloud, France., Ung M; Department of Oncology, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France., Cristol-Dalstein L; Department of Medical Oncology, Institut du Cancer de Montpellier, Montpellier, France., Mouret-Reynier MA; Department of Medical Oncology, Centre Jean Perrin, Clermont Ferrand, France., Goncalves A; Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France., Abadie-Lacourtoisie S; Department of Medical Oncology, Institut de Cancérologie de l'Ouest Nantes & Angers, France., Francois E; Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France., Perrin C; Department of Medical Oncology, Centre Eugéne Marquis, Rennes, France., Le Fel J; Department of Medical Oncology, Centre Henri Becquerel, Rouen, France., Lorgis V; Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France., Servent V; Department of Medical Oncology, Centre Oscar Lambret, Lille, France., Uwer L; Department of Medical Oncology, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France., Jouannaud C; Department of Medical Oncology, Institut de Cancérologie Jean-Godinot, Reims, France., Leheurteur M; Department of Medical Oncology, Centre Henri Becquerel, Rouen, France., Joly F; Department of Medical Oncology, Centre François Baclesse, Caen, France., Campion L; Oncology Data Factory and Analytics, Institut de Cancérologie de l'Ouest, France; CRCINA, University of Nantes, INSERM UMR 1232, CNRS-ERL6001, Nantes, France., Courtinard C; Epicene Team (Cancer & Environnement), Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France; Unicancer, Direction des Données, Paris, France., Villacroux O; Institut de Cancérologie de l'Ouest Nantes & Angers, France., Petit T; Department of Medical Oncology, Centre Paul Strauss, Strasbourg, France., Soubeyran P; Department of Medical Oncology, Institut Bergonié, Bordeaux, France., Terret C; Department of Medical Oncology, Centre Leon Berard, Lyon, France., Bellera C; Clinical and Epidemiological Research Unit, Institut Bergonié, Bordeaux, France; Epicene Team (Cancer & Environnement), Bordeaux Population Health Center, ISPED, Centre INSERM U1219, INSERM, Bordeaux, France., Brain E; Department of Medical Oncology, Institut Curie, Saint-Cloud, France., Delaloge S; Department of Cancer Medicine, Gustave Roussy, Villejuif, France. Electronic address: suzette.delaloge@gustaveroussy.fr.
Jazyk: angličtina
Zdroj: Breast (Edinburgh, Scotland) [Breast] 2021 Dec; Vol. 60, pp. 138-146. Date of Electronic Publication: 2021 Oct 01.
DOI: 10.1016/j.breast.2021.09.011
Abstrakt: Background: Treatment and outcomes of patients with HER2-positive (HER2+) metastatic breast cancer (MBC) have dramatically improved over the past 20 years. This work evaluated treatment patterns and outcomes according to age.
Methods: Women who initiated a treatment for HER2+ MBC between 2008 and 2016 in one of the 18 French comprehensive centers part of the ESME program were included. Objectives were the description of first-line treatment patterns, overall survival (OS), first-line progression-free survival (PFS), and prognostic factors among patients aged 70 years or more (70+), or less than 70 (<70).
Results: Of 4045 women diagnosed with an HER2+ MBC, 814 (20%) were 70+. Standard first-line treatment (chemotherapy combined with an anti-HER2 therapy) was prescribed in 65% of 70+ versus 89% of <70 patients (p < 0.01). Median OS was 49.2 (95% CI, 47.1-52.4), 35.3 (95% CI, 31.5-37.0) and 54.2 months (95% CI, 50.8-55.7) in the whole population, in patients 70+ and <70, respectively. Corresponding median PFS1 were 12.8 (95% CI, 12.3-13.3), 11.1 (95% CI, 10.0-12.3) and 13.2 months (95% CI, 12.7-13.9), respectively. In 70+ women, initiation of non-standard first-line treatment had an independent detrimental time-varying effect on both OS and PFS (HR on OS at 1 year: chemotherapy without anti-HER2 2.79 [95% CI: 2.05-3.79]; endocrine therapy and/or anti-HER2 1.96 [95% CI: 1.43-2.69]).
Conclusions: In this large retrospective real-life database, older women with HER2+ MBC received standard first-line treatment less frequently than younger ones. This was independently associated with a worse outcome, but confounding factors and usual selection biases cannot be ruled out.
(Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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