265P - Survival of patients with aromatase inhibitors sensitive, HR+/HER2- metastatic breast cancer treated with a first-line endocrine therapy or chemoth...

Date 11 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Metastatic
Breast Cancer
Presenter Emmanuelle JACQUET
Citation Annals of Oncology (2017) 28 (suppl_5): v74-v108. 10.1093/annonc/mdx365
Authors E. JACQUET1, A. Lardy-Cleaud2, B. PISTILLI3, P. Cottu4, S. Delaloge5, M. Debled6, L. Vanlemmens7, G. Anne-Valérie8, M. Leheurteur9, L. Laborde10, W. Jacot11, D. Berchery12, B. Coudert13, J. Ferrero14, D. Parent15, V. Diéras16, M. Velten17, C. Courtinard18, M. Robain19, T. Bachelot20
  • 1Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 2Statistics, Centre Léon Bérard, 69008 - Lyon/FR
  • 3Oncology, GUSTAVE ROUSSY, 94800 - Villejuif/FR
  • 4Medical Oncology, Institut Curie, Paris/FR
  • 5Breast Cancer Group, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 6Medical Oncology, Institute Bergonié, 33076 - Bordeaux/FR
  • 7Medical Oncology, Centre Oscar Lambret, 59020 - Lille/FR
  • 8Medical Oncology, Centre François Baclesse, Caen/FR
  • 9Oncologie Médicale, Centre Henri Becquerel, 76038 - Rouen Cedex/FR
  • 10Unité De Gestion Des Données, Institut Paoli Calmettes, 13009 - Marseille/FR
  • 11Department Of Medical Oncology, ICM Regional Cancer Institute of Montpellier, 34298 - Montpellier/FR
  • 12Epidemiology, Institut Claudius Regaud, 31100 - Toulouse/FR
  • 13Oncology, Centre Georges-François Leclerc (Dijon), 21000 - Dijon/FR
  • 14Department Of medical Oncology, Centre Antoine Lacassagne, 06100 - Nice/FR
  • 15Medical Oncology, Institut Jean Godinot, 51100 - Reims/FR
  • 16Department Of Medical Oncology, Center Eugène Marquis, Rennes/FR
  • 17Medical Oncology, Centre Paul Strauss, 67065 - Strasbourg/FR
  • 18Research And Development, Unicancer, Paris/FR
  • 19Medical Data Director/esme Program, Unicancer, Paris/FR
  • 20Département D'oncologie Médicale Adulte, Centre Léon Bérard, 69008 - Lyon/FR

Abstract

Background

For HR+/HER2– metastatic breast cancer (mBC), international guidelines recommend the use of endocrine therapy (ET) as first-line (L1) treatment except in case of “visceral crisis” for which chemotherapy (CT) is advised. Few studies directly compare these two treatment options. In 2014, UNICANCER launched the Epidemiological Strategy and Medical Economics (ESME) Research program to centralize real-world data in oncology. We sought to use this database to study this question.

Methods

All patients (pts) who initiated treatment for a newly diagnosed mBC between January 2008 and December 2014 in all 18 French Comprehensive Cancer Centers were included in the ESME mBC database. ESME Research program centralized all existing data using retrospective data collection. Primary endpoint of the present study was progression free survival (PFS1) and overall survival (OS) according to L1 treatment for aromatase inhibitors sensitive (AIS) HR+/HER2- mBC pts.

Results

6265 pts out of 16703 in ESME, had AIS HR+/HER2- mBC. As L1 therapy, 2733 pts (43.6%) received ET alone, while 3532 received CT (56.4%). Among these 3532 pts, 2073 (58.7%) received ET as maintenance treatment after CT. A Cox multivariate analysis with significant prognostic variables identified a lower risk of death in the patients with L1 ET (HR = 0.839, 95% IC [0.772-0.911], p 

Conclusions

The results show that despite guidelines, a majority of AIS HR+/HER2- mBC pts still received CT as first-line treatment in the past years. PFS1 and OS data do not suggest any advantage of this aggressive strategy over ET alone. Advanced statistical methods using the propensity score will be presented in order to control for potential selection bias.

Clinical trial identification

Legal entity responsible for the study

UNICANCER

Funding

UNICANCER

Disclosure

All authors have declared no conflicts of interest.