401P - Everolimus plus hormonotherapy (HT) induces survival gain in late metastatic breast cancer (MBC) after progression: Could this line be better than...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Breast Cancer, Metastatic
Presenter Mélanie Pouget
Citation Annals of Oncology (2014) 25 (suppl_4): iv116-iv136. 10.1093/annonc/mdu329
Authors M. Pouget1, E. Planchat2, C. Abrial3, I. van Praagh3, M. Arbre2, F. Kwiatkowski3, P. Dubray-Longeras3, H. Devaud4, Q. Wang-Lopez1, H. Mahammedi5, X. Durando6, P. Chollet1, M. Mouret-Reynier3
  • 1Division De Recherche Clinique, Centre Jean Perrin ; University Clermont 1 ; Centre d'Investigation Clinique, UMR 990 INSERM, 63011 - Clermont Ferrand/FR
  • 2Division De Recherche Clinique, Centre Jean Perrin, 63011 - Clermont Ferrand/FR
  • 3Division De Recherche Clinique, ERTICA EA 4677, Université d'Auvergne; Centre Jean Perrin ; Centre d'Investigation Clinique, 63011 - Clermont Ferrand/FR
  • 4Division De Recherche Clinique, Centre Jean Perrin ; University Clermont 1 ; Centre d'Investigation Clinique, 63011 - Clermont Ferrand/FR
  • 5Division De Recherche Clinique, Centre Jean Perrin ; Centre d'Investigation Clinique, 63011 - Clermont Ferrand/FR
  • 6Division De Recherche Clinique, Centre Jean Perrin ; University Clermont 1 ; Centre d'Investigation Clinique; CREaT EA 7283, 63011 - Clermont Ferrand/FR

Abstract

Aim

Everolimus (Afinitor®) is indicated for the treatment of hormone receptor-positive, HER2/neu negative MBC, combined with exemestane, in postmenopausal women without symptomatic visceral disease after recurrence or progression following a non-steroidal aromatase inhibitor. However late patients after several lines may also benefit from new therapies, and we report here our experience on MBC patients pre-treated by a median of 3 CT and 2 HT lines at metastatic stage.

Methods

63 MBC patients progressing under HT (30) or after CT (32) received between 2012 and 2014 the association of everolimus and HT for a median duration of 27.8 weeks, by addition to the same (12) or a different (18) HT at the initial dose of 5-10 mg /day until progression or toxicity. Dose was adapted to the clinical tolerance, similarly to the published experience. Overall survival (OS) was calculated from the onset of the association, to last report or death. Patients were compared with our published database of 530 MBC patients stratified by treatment line (Planchat et al, The Breast, 2011, 20:574-8).

Results

At the cutoff date (02/2014), median OS was not reached after a median follow up of 18 months and 18 patients had died. At 12 months, the survival rate was respectively 100, 79 and 49 % for patients pre-treated by 0 (n = 13), 1-2 (n = 18 ), ≥3 (n = 32) CT lines when metastatic. Median Time-to-treatment failure (progression or everolimus stopped for toxicity) was 6.39 months, but the clinician did not always change HT treatment line immediately. We realized a paired study where 62 patients under association were randomly matched with 421 registered MBC on 2 criteria: (1) age by 5-year intervals; (2) number of previous CT lines. Then OS under everolimus plus HT tended to be better than a new CT (p = 0.062). The Everolimus-containing line resulted in a longer OS for patient pre-treated by ≤ 2 lines of CT (p = 0.026), but was similar to a new line after ≥ 3 previous CT-lines, respectively 12 versus 11 months.

Conclusions

These results may support the use of everolimus plus HT, as a supplementary late line, whatever the number of previous CT lines, and deserves more prospective trials.

Disclosure

All authors have declared no conflicts of interest.