Abstract 3447
Background
Conflicting results on the the impact of cancer first treatment delay (FTD) on survival have been reported between several studies, and its importance has yet to be determined. We currently do not have any study in breast cancer (BC) analyzing how FTD influences the prognosis of the patients according to different inmunophenotypes. We conducted a study where we examined the relationship between survival and three periods of diagnostic-therapeutic delay, 30, 60 and 90 days.
Methods
This multicentre cohort study included BC patients from screening CAMISS PROJECT, during 2000-2006 with follow-up until 2014. Cox regression analysis, crude and multivariate, was applied to estimate risk of death. The Hazard Ratio (HR) was adjusted by FTD, stage, immunophenotypes of BC and comorbidity
Results
The study included 738 women aged 45-69 years. Median time of FTD was 58 days. First treatment aplied was surgery for all populations. 42% of BC presented as stage I and 34% stage II. 24% of patients had comorbidities. 21% expressed HER2, 80% estrogen receptors and 61% progresterone. There were 53% of Luminal A tumors, followed by 27% Luminal B, of which 10% also expressed HER2, 9% were HER2 overexpressing tumors, and 11% triple negative. In the crude analysis none of the three FDT cut-off points had a significant relationship with overall survival. Multivariate analysis adjusted for phenotypes, comorbidity and stage, showed worse prognosis tendency in DT30 and DT90, with a statistically significant level in DT60, hazard ratio [HR] 1,57; 95% IC (1,04-2,38). When we analyzed survival according to DT60 and BC subtypes there was more significant risk of death among HER2 subtype HR 2,91; 95% IC (1,63-5,21) and triple negative HR 1,90; 95% IC(1,01-3,60) comparing to Luminal A. No relationship was seen in Luminal B; Table.Table:
251P
aHR30 | aHR60 | aHR90 | ||
---|---|---|---|---|
Treatment delay (days) | <30 | Ref | ||
> =30 | 1,53 (0,84-2,78) | |||
<60 | R | |||
> =60 | 1,57 (1,04-2,38) | |||
<90 | Ref | |||
> =90 | 1,72(1,00-2,95) | |||
Stage | I | Ref | Ref | Ref |
InSitu | 0,29 (0,07-1,24) | 0,29 (0,07-1,23) | 1,47 (0,89-2,44) | |
II | 1,40 (0,84-2,33) | 1,38 (0,83-2,30) | 3,01 (1,67-5,41) | |
III | 4,42 (2,66-7,35) | 4,43 (2,67-7,35) | 1,95 (1,02-3,72) | |
Fenotipe | Luminal A | Ref | Ref | Ref |
Luminal B | 1,40 (0,85-2,31) | 1,45 (0,88-2,40) | 0,29 (0,07-1,22) | |
Her2 | 2,89 (1,62-5,18) | 2,91 (1,63-5,21) | 1,38 (0,83-2,31) | |
Triple Negative | 1,96 (1,01-3,66) | 1,90 (1,01-3,60) | 4,23 (2,56-7,01) | |
Comorbidity | Absence | Ref | Ref | Ref |
Presence | 1,63 (1,06-2,52) | 1,61 (1,04-2,48) | 1,59 (1,03-2,46) |
Conclusions
Waiting 60 days to initiate treatment was associated with a significantly worse overall survivall among triple negative and HER2 BC. We consider it of importance to offer early treatment to aggressive BC subtypes.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
REDISSEC-CAMISS Group-(Research Network in Health Services in Chronic Diseases).
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3191 - The efficacy and safety of lenvatinib in patients who did not meet the inclusion criteria of the phase 3 trial (REFLECT trial) and those with BCLC Stage B hepatocellular carcinoma - A nationwide multicenter study in Japan-
Presenter: Azusa Sakamoto
Session: Poster Display session 2
Resources:
Abstract
1529 - Prognostic and predictive value of baseline alpha-fetoprotein (AFP) in patients with advanced hepatocellular carcinoma (HCC) treated with ramucirumab from two phase 3 studies (REACH, REACH-2)
Presenter: Andrew Zhu
Session: Poster Display session 2
Resources:
Abstract
2767 - Effect of second-line cabozantinib on health states for patients with advanced hepatocellular carcinoma (aHCC) after sorafenib: QTWiST analysis from the CELESTIAL study
Presenter: Nicholas Freemantle
Session: Poster Display session 2
Resources:
Abstract
2150 - Alpha-fetoprotein (AFP) response in patients with unresectable hepatocellular carcinoma (HCC) in the phase 3 RESORCE trial
Presenter: Jordi Bruix
Session: Poster Display session 2
Resources:
Abstract
3437 - Phase I/II trial of NBTXR3 activated by SBRT in patients with hepatocellular carcinoma or liver metastasis
Presenter: Marc Pracht
Session: Poster Display session 2
Resources:
Abstract
1758 - Efficacy and safety of ramucirumab (RAM) for advanced hepatocellular carcinoma (HCC) with elevated alpha-fetoprotein (AFP) following first-line sorafenib across age subgroups in two global phase 3 trials (REACH and REACH-2)
Presenter: Masatoshi Kudo
Session: Poster Display session 2
Resources:
Abstract
1192 - Ramucirumab in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha fetoprotein (AFP): An exposure–response analysis
Presenter: Josep Llovet
Session: Poster Display session 2
Resources:
Abstract
1600 - Outcomes of Hepatocellular Carcinoma (HCC) Patients Treated with Nivolumab: The Mount Sinai Hospital Experience.
Presenter: Sirish Dharmapuri
Session: Poster Display session 2
Resources:
Abstract
2364 - Pembrolizumab vs Chemotherapy in Patients With Advanced/Metastatic Adenocarcinoma (AC) or Squamous Cell Carcinoma (SCC) of the Esophagus as Second-Line Therapy: Analysis of the Chinese Subgroup in KEYNOTE-181
Presenter: Jia Chen
Session: Poster Display session 2
Resources:
Abstract
1933 - A national comparative effectiveness study to assess definitive chemoradiation regimens in proximal oesophageal squamous cell cancer
Presenter: Judith de Vos-Geelen
Session: Poster Display session 2
Resources:
Abstract