279MO - Divergent evolution of overall survival across metastatic breast cancer (MBC) subtypes in the nationwide ESME real life cohort 2008-2016

Background

Treatment (trt) strategies for HER2+ and HER2-/hormone receptor-positive (HR+) MBC have made great strides over the past 10 years (yrs). Real world data evaluate the final impact of care strategies.

Methods

ESME gathers full clinical data of all pts who initiated MBC trt in 18 French Cancer Centers between 01/2008-12/2016 (N=22109). Primary objective: prognostic effect of yr of diagnosis (YOD) on overall survival (OS) among pts with the 3 main subtypes: HR+/HER2- (n = 13656), HER2+ (n = 4017), triple-negative (TNBC) (n = 2963). We used multivariate adjusted Cox regression analyses including classical prognostic factors (R software).

Results

Median follow-up was 51.8 months (mo) (95%CI 51-52.7). YOD had no effect on the OS of TNBC pts. However, YOD >2013 appeared as an independent predictor of better OS in pts with HER2+ MBC, while it had an opposite effect in HR+/HER2- cases (Table). In the latter, median OS was 36.7 mo (95% CI: 35-38.7) YOD 2015 versus 44.5 mo (42.1-47.7) YOD 2008. Several sensitivity analyses showed similar trends. We will present explanatory analyses. Unlike baseline characteristics and adjuvant trts, MBC trts progressively changed during this pre-CDK period (including less CT). Table: 279MO

Conclusions

OS of pts with HER2+ MBC has dramatically improved over the past decade. However, it unexpectedly worsened among those with luminal cancers. These data prompt careful surveillance of real life outcomes as indicators of the final impact of global trt strategies.

Clinical trial identification

NCT0327531.

Editorial acknowledgement

Legal entity responsible for the study

Unicancer.

Funding

Pfizer, Roche, AstraZeneca, Daiichi, Pierre Fabre, Novartis.

Disclosure

S. Delaloge: Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer; Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (institution), Research grant/Funding (institution): Puma; Honoraria (institution), Research grant/Funding (institution): Sanofi; Honoraria (institution), Research grant/Funding (institution): BMS; Honoraria (institution), Research grant/Funding (institution): Pierre Fabre; Research grant/Funding (institution): Novartis; Honoraria (institution), Research grant/Funding (institution): Lilly; Research grant/Funding (institution): Daiichi. W. Jacot: Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Travel/Accommodation/Expenses: Eisai; Honoraria (self), Travel/Accommodation/Expenses: Lilly; Honoraria (self): MSD; Honoraria (self), Travel/Accommodation/Expenses: Novartis; Honoraria (self), Travel/Accommodation/Expenses: Pfizer; Travel/Accommodation/Expenses: Sanofi; Honoraria (self), Travel/Accommodation/Expenses: Roche. P.H. Cottu: Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (self): Lilly; Research grant/Funding (institution): Novartis. F. Dalenc: Travel/Accommodation/Expenses: Roche; Honoraria (institution), Travel/Accommodation/Expenses: Pfizer; Honoraria (institution): Roche. A. Gonçalves: Honoraria (institution), Research grant/Funding (institution), Travel/Accommodation/Expenses: Novartis; Honoraria (institution), Research grant/Funding (institution): MSD; Honoraria (institution): Lilly; Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: AstraZeneca; Travel/Accommodation/Expenses: Pfizer. A. Patsouris: Honoraria (institution): Lilly; Honoraria (institution), Travel/Accommodation/Expenses: Eisai; Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: Pfizer. A. Mailliez: Honoraria (institution): Pfizer; Travel/Accommodation/Expenses: AstraZeneca; Travel/Accommodation/Expenses: Pierre Fabre. F. Clatot: Honoraria (self), Travel/Accommodation/Expenses: BMS; Honoraria (self), Travel/Accommodation/Expenses: Lilly; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Roche; Honoraria (self), Travel/Accommodation/Expenses: Merck; Research grant/Funding (self): AstraZeneca. C. Levy: Honoraria (self): Pfizer; Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self): MSD; Honoraria (self), Travel/Accommodation/Expenses: Lilly; Travel/Accommodation/Expenses: Daiichi. M. Robain: Research grant/Funding (institution): Roche; Research grant/Funding (institution): Pfizer; Research grant/Funding (institution): AstraZeneca; Research grant/Funding (institution): MSD; Research grant/Funding (institution): BMS; Research grant/Funding (institution): Daiichi; Research grant/Funding (institution): GSK. T. Bachelot: Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Novartis; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Research grant/Funding (institution), Travel/Accommodation/Expenses: Pfizer; Honoraria (self): Seattle genetics. E. Brain: Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self): BMS; Honoraria (self): Celgene; Honoraria (self): Clinigen; Honoraria (self): G1 therapeutics; Honoraria (self): Hospira; Honoraria (self): Jansen; Honoraria (self): Mylan; Honoraria (self): OBI pharma; Honoraria (self): Pfizer; Honoraria (self): Puma; Honoraria (self), Travel/Accommodation/Expenses: Roche; Honoraria (self): Samsung; Travel/Accommodation/Expenses: Novartis; Travel/Accommodation/Expenses: Pierre Fabre; Travel/Accommodation/Expenses: Sandoz. D. Perol: Honoraria (self), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self): BMS; Honoraria (self): Lilly; Honoraria (self): Ipsen; Honoraria (self): Roche; Honoraria (self): Novartis; Honoraria (self): Pierre Fabre; Honoraria (self): MSD; Honoraria (self): Takeda. All other authors have declared no conflicts of interest.