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Poster Display session 2

3093 - Changes in Hormone-Receptor status in Luminal breast cancers between primary tumor and metastases: results of the observational cohort GIM-13 AMBRA Study

Date

29 Sep 2019

Session

Poster Display session 2

Topics

Tumour Site

Breast Cancer

Presenters

Marina Cazzaniga

Citation

Annals of Oncology (2019) 30 (suppl_5): v104-v142. 10.1093/annonc/mdz242

Authors

M.E. Cazzaniga1, P. Pronzato2, L. Del Mastro3, C. Natoli4, F. Montemurro5, G. Bisagni6, L. Blasi7, A. Turletti8, M. Giordano9, L. Biganzoli10, A. Michelotti11, O. Garrone12, P. Marchetti13, F. Riccardi14, A. Bernardo15, L. Livi16, F. Cognetti17, M. Donadio18, E. Romagnoli19, G. Mustacchi20

Author affiliations

  • 1 Medical Oncology & Phase 1 Research Unit, Azienda Ospedaliera S. Gerardo - Oncologia Medica, 20900 - Monza/IT
  • 2 Medical Oncology, Ospedale St. Andrea, 19100 - La Spezia/IT
  • 3 Internal Medicine Dept., IRCCS AOU San Martino - IST-Istituto Nazionale per la Ricerca sul Cancro, 16132 - Genova/IT
  • 4 Medical Oncology & Phase 1 Research Unit, Ospedale Clinicizzato SS. Annunziata - Chieti - Policlinico, 66100 - Chieti/IT
  • 5 Investigative Clinical Oncology, Istituto di Candiolo - FPO - IRCCS, 10060 - Candiolo/IT
  • 6 Medical Oncology, Azienda Ospedaliera Arcispedale Santa Maria Nuova - IRCCS, 42100 - Reggio Emilia/IT
  • 7 Medical Oncology, Fondazione Istituto San Raffaele - G. Giglio di Cefalù, 90015 - Cefalù/IT
  • 8 Medical Oncology, ASL "Città di Torino", 10121 - Torino/IT
  • 9 Medical Oncology, Presidio Ospedaliero Ospedale Sant'Anna, 22100 - San Fermo della Battaglia/IT
  • 10 Medical Oncology, Ospedale di Prato Sandro Pitigliani Med. Oncology Unit, 59100 - Prato/IT
  • 11 Medical Oncology, Azienda Ospedaliera Universitaria S.Chiara, 56100 - Pisa/IT
  • 12 Medical Oncology, Azienda Ospedaliera St. Croce e Carle, 12100 - Cuneo/IT
  • 13 Medical Oncology, Sapienza, University of Rome, Medical Oncology Unit, 00189 - Rome/IT
  • 14 Medical Oncology, AORN Cardarelli, UOC di Oncologia, 80121 - Napoli/IT
  • 15 Medical Oncology, Fondazione S. Maugeri IRCCS, 27100 - Pavia/IT
  • 16 Radiation Oncology, AOU Careggi - Radioterapia Oncologica, 50121 - Firenze/IT
  • 17 Medical Oncology, Istituto Nazionale Tumori Regina Elena, 00144 - Rome/IT
  • 18 Medical Oncology, AOU Città della Salute e della Scienza Torino, 10128 - Torino/IT
  • 19 Uo Oncologia, Ospedale Generale Provinciale Macerata, 62100 - Macerata/IT
  • 20 Dip Universitario Clinico Di Scienze Mediche, Chirurgiche E Della Salute, University of Trieste-Ospedale di Cattinara, 34149 - Trieste/IT

Resources

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Abstract 3093

Background

Tumor phenotype may change during breast cancer (BC) progression and discordance between primary and metastases ranges between 16% and 21% for Hormone Receptor (HR) expression in some series. The impact of this change on patient (pts) management and outcome is not yet clear, even though preliminary data indicate that the molecular characterization of recurrent breast cancer may induce clinicians to modify the treatment choice in ∼14% of the cases and that a change in the receptor status is associated with poorer survival. This analysis evaluates the prognostic impact of receptor discordance between paired primaries and recurrences.

Methods

We used data of 879 pts of the longitudinal cohort AMBRA study, identifying 3 different groups: Group A: HR+ BC remaining HR+ at relapse; Group BHR+ BC becoming TNBC; Group C:TNBC remaining TNBC. Change in HR status was evaluated on the biopsy done at the moment of relapse. Time to event was evaluated by Cox-Mantel Hazard Ratio and Logrank Test; Mean/median by Wilcoxon Rank-Sum Test.

Results

Pts who underwent biopsy at the time of relapse were 545/879 (62%), of those 462 (84.4%) were classified as Luminal tumors and 83 (15.2%) TNBC on primary. Change in tumor phenotype occurred in 31 (6.7%) of Luminal BC and 16 (19.3%) TNBC, probably due to a higher genomic instability (p = 0.021). Median DFS between Luminal BC was not different: HR+àHR+: 74.56 months (95%CI 66.8-82.1) vs HR+àTNBC: 89.73 months (95%CI:44.73-103.46). Table summarizes main data in time to event in the 3 identified groups. *PFS at 1strelapse; **PFS at 2nd relapse; ***Time to Treatment Change at 1strelapse; °OS at 1strelapse; §OS from 1stPDTable:

325P

HR+/HR +  (range) Group AHR+/TNBC (range) Group Bp value Group A vs CTNBC/TNBC (range) Group C
PFS1* (months)13.65 (0,77-162,03)9.45 (3,97-52,73)0.368.13 (6.3-10.9)
PFS2** (months)6.83 (0,00-57,13)6.12 (2,67-26,30)0.844.20 (0,33-22,17)
TTC1*** (months)12.43 (0,13-163,10)8.88 (0,00-48,40)0.507.88 (0,23-27,80)
TTC2**** (months)7.45 (0,00-55,97)6.73 (3,77-26,80)nana
OS1° (months)23.1 (20-26)15 (8.7-26.3)0.0313.60 (0,60-25,38)
OS (years)8.52 (0,26-115,92)7.86 (0,19-30,67)0.433.58 (2.91-2.39)
OS from PD1§ (months)25.8 (0,00-207,53)17.23 (2,67-104,30)0.8217.90 (2,37-53,57)
.

Conclusions

Change in tumor phenotype has a significant impact on OS; BC pts who become TNBC at relapse should be treated in the same way as TNBC pts at diagnosis. Anyway, OS of Luminal BC who change phenotype seems to be better than TNBC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

GIM - Gruppo Italiano Mammella.

Funding

Celgene.

Disclosure

All authors have declared no conflicts of interest.

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