Abstract 4598
Background
The majority of patients with metastatic breast cancer (MBC) receive non-targeted cytotoxic chemotherapy during their disease trajectory. Its use however near the end of life has not been extensively studied and it’s possible that patients with advanced disease may be exposed to unnecessary aggressive treatment.
Methods
Patients who were diagnosed with MBC in 2010-2015 were identified from the Stockholm-Gotland Breast Cancer Registry. Data regarding tumor characteristics, date of MBC diagnosis and death were collected from the registry. Data on chemotherapy use during the final month of the patient’s life, type of chemotherapy regimen used and albumin levels – a surrogate marker for performance status – were collected from individual patient files. Analysis of overall survival of the entire cohort was made in order to estimate contemporary survival of MBC patients.
Results
In total, 1571 patients were identified. Out of 1559 patients included in the survival analysis, there were 1357 deaths and 202 patients still alive. Chemotherapy during the last month of life was given to 23.2% of the patients, more commonly to patients ≤60 years old (35.6% versus 18.5%, p < 0.001). A new treatment regimen was initiated in 8.4% of patients. Both albumin (OR 0.95, 95% CI 0.92 – 0.98, p = 0.002) and age at the time of diagnosis (OR 1.04, 95% CI 1.02 – 1.05, p < 0.001) predicted the administration of chemotherapy. The most commonly used chemotherapeutic was capecitabine (24.8%), followed by paclitaxel (14.6%) and vinorelbine (9.8%). After a median follow-up of 73.4 months, median overall survival in the entire cohort was 16.73 months (95% CI 15.22–18.24); patients ≤60 years-old had better median survival compared to older ones (24.83, 95% CI 20.61-29.05 versus 13.86 months, 95% CI 12.72-15.74; p < 0.001).
Conclusions
Chemotherapy use near the end of life was common, especially among younger patients. Median overall survival at the population level is considerably worse as compared to results from randomized trials. This may reflect on the differences in patient characteristics and completeness of registry data, which include patients that were never treated for MBC.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
J. Bergh: Research grant / Funding (institution): Merck; Research grant / Funding (institution): Amgen; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Roche; Research grant / Funding (institution): Pfizer; Research grant / Funding (institution): Sanofi-Aventis; Honoraria (self): UpToDate. T. Foukakis: Honoraria (self), Research grant / Funding (institution): Roche; Honoraria (self), Research grant / Funding (institution): Pfizer; Honoraria (self): Novartis; Honoraria (self): UpToDate. All other authors have declared no conflicts of interest.
Resources from the same session
4616 - Alpelisib (ALP) + Endocrine Therapy (ET) by Last Prior Therapy in Patients (pts) With PIK3CA-Mutated Hormone-Receptor Positive (HR+) Human Epidermal Growth Factor Receptor-2-Negative (HER2–) Advanced Breast Cancer (ABC): Additional Study Cohort in BYLieve
Presenter: Eva Ciruelos
Session: Poster Display session 2
Resources:
Abstract
3592 - PRECYCLE: Impact of CANKADO-based eHealth-support on quality of life in metastatic breast cancer patients treated with palbociclib and endocrine therapy.
Presenter: Tom Degenhardt
Session: Poster Display session 2
Resources:
Abstract
4168 - Efficacy and safety of oral poly (ADP-ribose) polymerase inhibitor fluzoparib in patients with BRCA1/2 mutations and platinum sensitive recurrent ovarian cancer
Presenter: Ning Li
Session: Poster Display session 2
Resources:
Abstract
2785 - Effect of response to last platinum-based chemotherapy in patients (pts) with platinum-sensitive, recurrent ovarian carcinoma in the phase 3 study ARIEL3 of rucaparib maintenance treatment
Presenter: Jonathan Ledermann
Session: Poster Display session 2
Resources:
Abstract
3496 - Integrated safety analysis of the poly(ADP-ribose) polymerase (PARP) inhibitor rucaparib in patients (pts) with ovarian cancer in the treatment and maintenance settings
Presenter: Rebecca Kristeleit
Session: Poster Display session 2
Resources:
Abstract
2844 - Clinical factors associated with prolonged response and survival under olaparib as maintenance therapy in BRCA mutated ovarian cancers
Presenter: S.Intidhar Labidi-Galy
Session: Poster Display session 2
Resources:
Abstract
1955 - A Prospective Evaluation of Tolerability of Niraparib Dosing Based on Baseline Body Weight (BW) and Platelet (plt) Count: Blinded Pooled Interim Safety Data from the NORA Study
Presenter: Xiaohua Wu
Session: Poster Display session 2
Resources:
Abstract
2539 - Evaluation of Niraparib 200 mg/d as Maintenance Therapy in Recurrent Ovarian Cancer and Associated Thrombocytopenia in a Real-World US Setting
Presenter: Premal Thaker
Session: Poster Display session 2
Resources:
Abstract
1290 - Niraparib initial dose and its’ management in patients with recurrent high-grade serous ovarian cancer.
Presenter: Jacek Grabowski
Session: Poster Display session 2
Resources:
Abstract
3353 - Results of the 3rd interim analysis of C-Patrol: A non-interventional study on olaparib in German routine clinical practice
Presenter: Jalid Sehouli
Session: Poster Display session 2
Resources:
Abstract