Many Patients With HR+ Disease Receive Initial Palliative Chemotherapy, Despite Worse Outcomes
Use of initial palliative chemotherapy for patients with hormone receptor positive breast cancer is associated with poorer outcomes.
Although the use of initial palliative chemotherapy for patients with hormone receptor positive (HR+) metastatic breast cancer is associated with poorer outcomes, a study determined that a high percentage of HR+ patients receive this therapy. This study was published online ahead of print in the journal Annals of Oncology.1
A research team based in the Netherlands (corresponding author Professor Vivianne C.G. Tjan-Heijnen, Department of Medical Oncology, Maastricht University Medical Center) identified 611 patents from the 8 participating medical facilities with HR+ disease (out of a total of 815 with metastatic breast cancer).
The investigators reviewed palliative systemic treatment and determined both overall survival (OS) and progression-free survival (PFS) using the Kaplan-Meier method.
Four hundred eighty-two patients of the 520 with HR+/HER2- metastatic breast cancer received palliative systemic therapy, approximately 93%. The 116 patients receiving initial chemotherapy had less comorbidity and displayed less bone metastasis than those persons who received endocrine therapy initially.
Median PFS for those receiving initial palliative chemotherapy was much lower than for receiving initial endocrine therapy (5.3 months vs 13.3 months, respectively). Worse outcomes were also observed for progression-free survival and overall survival for those receiving initial chemotherapy.
1. Lobbezoo DJ, van Kampen RJ, Voogd AC, et al. In real life, one-quarter of patients with hormone receptor positive metastatic breast cancer receive chemotherapy as initial palliative therapy: a study of the Southeast Netherlands Breast Cancer Consortium [published online ahead of print November 16, 2015]. Ann Oncol. doi:10.1093/annonc/mdv544.