Abstract 3977
Background
There is little current evidence for the optimal primary treatment (PT) for patients with recurrent metastatic hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer. These patients may be resistant to metastatic treatment due to continuous adjuvant endocrine therapy (ET). Here, we identify the significant factors correlating to prognosis in a retrospective study. Recognizing the prognostic factors for recurrent HR+/HER2- breast cancer may improve the delivery of healthcare to at-risk groups and play an important role in the treatment and care for these patients.
Methods
We performed a retrospective review of records from 236 patients with recurrent metastatic HR+/HER2- breast cancer who were diagnosed between January 2000 and December 2013 at Sakai City Medical Center and Kindai University Hospital, Japan. We assessed the clinicopathologic features, treatment patterns, and overall survival (OS) following diagnosis of first distant recurrence.
Results
Median OS after first recurrence was 3.73 years. Patients with longer disease free-survival (DFI) (≥2 years), a longer interval after the end of adjuvant ET (≥1 year), or first recurrence without liver metastasis had a significantly better prognosis (p < 0.001, p = 0.007, and p < 0.001, respectively). Patients with a good response to PT for first recurrence also had significantly better prognosis, regardless of ET or chemotherapy (p < 0.001). Longer DFI, no liver metastasis, and good response to PT were found to be independent prognostic factors for better OS in multivariate analysis (HR:0.467; 95%CI:0.291-0.750, p = 0.002, HR:0.443; 95%CI:0.285-0.688, p < 0.001, and HR:0.312; 95%CI:0.201-0.484, p < 0.001, respectively). Good responders to PT were also shown to have a significantly longer response to subsequent lines (p = 0.007).
Conclusions
Good response to PT for first recurrence may be the key to favorable OS for recurrent metastatic HR+/HER2- patients, regardless of visceral metastasis. In addition to a novel targeted agent, more optimal treatment to first recurrence could improve drug resistance and eventually lead to better prognosis.
Clinical trial identification
Legal entity responsible for the study
Sakai City Hospital Organization.
Funding
Has not received any funding.
Editorial Acknowledgement
Disclosure
All authors have declared no conflicts of interest.
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