23P - Combination chemotherapy and hormone therapy (CHT) in patients with hormone receptor (HR) positive, HER2 negative metastatic breast cancer (MBC): A single-centre retrospective analysis

Background

There are sparse data on outcomes with combined chemotherapy (CT) and hormonal therapy (HT) in MBC patients, including those with multiple prior treatments.

Methods

This was a retrospective analysis of HR-positive, HER2-negative MBC patients who were treated with a combination of CT (capecitabine or oral cyclophosphamide) and HT (tamoxifen or aromatase inhibitor or fulvestrant or megestrol acetate) between Jan 2015 and Dec 2020, with data cutoff in May 2022. Outcomes were progression-free survival (PFS) and overall survival (OS) from the start of CHT, and toxicity.

Results

A total of 224 patients with median age of 53 (26-91) years and median 3 (0-12) prior treatment lines were included. At median follow-up of 21.2 (1.7-87.0) months, 195 (87.1%) patients had experienced progression and 154 (68.8%) had died, with median PFS 8.8 (95% CI 7.0-10.6) months and median OS 16.7 (95% CI 13.5-19.9) months. In univariable analyses, ECOG PS [(/=2, n=142, 63.4%)] was significantly associated with PFS (14.9m vs 6.0m, HR 0.32, 95% CI 0.23-0.44, p<0.001) and OS (36.2m vs 11.0m, HR 0.29, 95% CI 0.20-0.42, p<0.001), duration of most recent HT [(>12 m, n=74, 33.0%) vs (/=4, n=81, 36.2%)] was not significantly associated with PFS and OS, visceral metastasis [(no, n=57, 25.4%) vs (yes, n=167, 74.6%)] was not significantly associated with PFS and OS, and CHT type [(capecitabine, n=196, 87.5%) vs (cyclophosphamide, n=26, 11.6%)] was not significantly associated with PFS and OS. In multivariable Cox analyses, better PS and fewer prior lines were significantly associated with higher PFS while better ECOG PS and capecitabine-based CHT were significantly associated with higher OS. CHT was well tolerated with 21 (9.4%) patients experiencing any grade>/=3 toxicity.

Conclusions

Chemo-hormonal therapy is an effective treatment in heavily pre-treated MBC patients, including those with visceral metastases.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.