Determining Clinicopathologic Factors That Influence Treatment in Advanced Breast Cancer in Argentina After CDK4/6 Inhibitors.

Autor:	Waisberg F; Breast Cancer Unit, Instituto Alexander Fleming, Buenos Aires, Argentina., Mandó P; Breast Cancer Unit, CEMIC, Buenos Aires, Argentina., Almada C; Breast Cancer Unit, Instituto Ángel Roffo, Buenos Aires, Argentina., Kassis N; Breast Cancer Unit, Instituto Ángel Roffo, Buenos Aires, Argentina., Mainella A; Clinical Oncology Unit, Centro de Oncología Integral, Buenos Aires, Argentina., Cermignani L; Breast Cancer Unit, Hospital Alemán, Buenos Aires, Argentina., Riggi MC; Breast Cancer Unit, Hospital Italiano, Buenos Aires, Argentina., Winocur M; Breast Cancer Unit, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., González R; Breast Cancer Unit, Clínica Universitaria Reina Fabiola, Córdoba, Argentina., Guercovich A; Clinical Oncology Unit, Centro Oncológico Integral, Neuquén, Argentina., Ayala N; Clinical Oncology Unit, Hospital J, Ramón Vidal, Corrientes, Argentina., Micheri C; Breast Cancer Unit, Instituto Oncológico de Rosario, Santa Fe, Argentina., Ituarte AC; Clinical Oncology Unit, Hospital J. P. Soria, Jujuy, Argentina., González Mattos L; Clinical Oncology Unit, Centro de Oncología de Integración Regional, Mendoza, Argentina., Llugdar P; Clinical Oncology Unit, Hospital María Curie, Buenos Aires, Argentina., Casalnuovo M; Clinical Oncology Unit, LUCEN, Buenos Aires, Argentina., Lutteral M; Clinical Oncology Unit, CABIN, Chubut, Argentina., Cinquini S; Clinical Oncology Unit, Hospital Británico, Buenos Aires, Argentina., Mazzotta A; Clinical Oncology Unit, Hospital Masvernat, Entre Ríos, Argentina., Lara Alcantara J; Clinical Oncology Unit, Hospital Álvarez, Buenos Aires, Argentina., Penayo R; Clinical Oncology Unit, Hospital de Alta Complejidad, Formosa, Argentina., Gomez-Abuin G; Breast Cancer Unit, Hospital Alemán, Buenos Aires, Argentina.
Jazyk:	angličtina
Zdroj:	JCO global oncology [JCO Glob Oncol] 2024 Sep; Vol. 10, pp. e2400056.
DOI:	10.1200/GO.24.00056
Abstrakt:	Purpose: The optimal treatment sequence for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC) after progression on first-line cyclin-dependent kinase 4/6 inhibitor (CDKi) and endocrine therapy is unclear. Clinical and biological factors influencing treatment choices and outcomes in the second-line setting need to be elucidated. Materials and Methods: This is a retrospective analysis of a real-world cohort including patients with HR+/HER2- ABC who received CDKi and endocrine therapy in the first-line setting and progressed, requiring second-line treatment. Clinical and biological factors were analyzed to evaluate their association with daily treatment decisions and the prognostic role of progression-free survival (PFS) in the second-line setting. Results: Two hundred thirty-five patients were included. Second-line treatments were hormone therapy (HT) based in 60% and chemotherapy based in 40% of patients. The second-line median PFS was 6.6 months, with no difference between treatment types. In multivariable analysis, postmenopausal status, lower Ki-67 expression, and non-de novo stage IV disease were associated with improved second-line (2L) PFS. Menopausal status significantly interacted with treatment type, with reduced PFS in premenopausal patients receiving HT-based treatments (4.7 v 8.7 months, P = .00045). Conclusion: In our study, treatment decisions reflected the current algorithm incorporated in our clinical guidelines, and prior treatment response was the most relevant factor to determine 2L treatment decision. Menopausal status interacted with the subsequent therapy efficacy in this setting. Hence, we consider that menopausal status should be routinely evaluated in the subgroup analysis of clinical trials.
Databáze:	MEDLINE
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