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
740 - A real-world analysis of the treatment of advanced ovarian cancer with PARPIs
Presenter: Alejandra Martinez de Pinillos
Session: Poster Display session 2
Resources:
Abstract
5867 - Incidence of tumour BRCA1/2 variants in relapsed, platinum-sensitive ovarian, fallopian tube and primary peritoneal cancer
Presenter: Robert Morgan
Session: Poster Display session 2
Resources:
Abstract
2966 - Frequency of mutations in 21 hereditary breast and ovarian cancer susceptibility genes among 882 high-risk individuals
Presenter: Jihong Liu
Session: Poster Display session 2
Resources:
Abstract
1687 - BRCA testing of 1,284 Brazilian patients for hereditary breast and ovarian cancer in a routine diagnostic setting
Presenter: Fernanda Milanezi
Session: Poster Display session 2
Resources:
Abstract
3162 - A multi-center integrative study on cancer predisposition genes in Chinese patients with epithelial ovarian carcinoma
Presenter: Changbin Zhu
Session: Poster Display session 2
Resources:
Abstract
5993 - Incidental Early Occult Ovarian Cancer after Risk-Reducing Salpingo-Oophorectomy in BRCA1/2 Mutation Carriers followed in a Community Public Hospital
Presenter: Begona Grana Suarez
Session: Poster Display session 2
Resources:
Abstract
5334 - Response to chemotherapy in ovarian cancer (OC) patients with or without prior breast cancer (BC), stratified by BRCA mutation (BRCAm) status
Presenter: Angela George
Session: Poster Display session 2
Resources:
Abstract
4565 - Advanced ovarian cancer: is residual disease after debulking surgery affected by genetics factors involved in angiogenesis and immunity pathways?
Presenter: Michele Bartoletti
Session: Poster Display session 2
Resources:
Abstract
3251 - Surrogate endpoint of progression-free (PFS) and overall survival (OS) for advanced ovarian cancer (AOC) patients (pts) treated with neo-adjuvant chemotherapy (NACT): Results of the CHIVA randomized phase II GINECO study
Presenter: Fabrice Lecuru
Session: Poster Display session 2
Resources:
Abstract
3278 - Immune-Related Gene Expression Profiling after Neoadjuvant Chemotherapy (NACT) of Ovarian High-Grade Serous Carcinoma
Presenter: Luis Manso
Session: Poster Display session 2
Resources:
Abstract