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Poster display session

3623 - Survival of patients with aromatase inhibitors sensitive, HR+/HER2- metastatic breast cancer treated with a first-line endocrine therapy or chemotherapy in a multicenter national observational study

Date

11 Sep 2017

Session

Poster display session

Presenters

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

Author affiliations

  • 1 Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 2 Statistics, Centre Léon Bérard, 69008 - Lyon/FR
  • 3 Oncology, GUSTAVE ROUSSY, 94800 - Villejuif/FR
  • 4 Medical Oncology, Institut Curie, Paris/FR
  • 5 Breast Cancer Group, Institut Gustave Roussy, 94800 - Villejuif/FR
  • 6 Medical Oncology, Institute Bergonié, 33076 - Bordeaux/FR
  • 7 Medical Oncology, Centre Oscar Lambret, 59020 - Lille/FR
  • 8 Medical Oncology, Centre François Baclesse, Caen/FR
  • 9 Oncologie Médicale, Centre Henri Becquerel, 76038 - Rouen Cedex/FR
  • 10 Unité De Gestion Des Données, Institut Paoli Calmettes, 13009 - Marseille/FR
  • 11 Department Of Medical Oncology, ICM Regional Cancer Institute of Montpellier, 34298 - Montpellier/FR
  • 12 Epidemiology, Institut Claudius Regaud, 31100 - Toulouse/FR
  • 13 Oncology, Centre Georges-François Leclerc (Dijon), 21000 - Dijon/FR
  • 14 Department Of medical Oncology, Centre Antoine Lacassagne, 06100 - Nice/FR
  • 15 Medical Oncology, Institut Jean Godinot, 51100 - Reims/FR
  • 16 Department Of Medical Oncology, Center Eugène Marquis, Rennes/FR
  • 17 Medical Oncology, Centre Paul Strauss, 67065 - Strasbourg/FR
  • 18 Research And Development, Unicancer, Paris/FR
  • 19 Medical Data Director/esme Program, Unicancer, Paris/FR
  • 20 Département D'oncologie Médicale Adulte, Centre Léon Bérard, 69008 - Lyon/FR
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Resources

Abstract 3623

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.

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