Anthropometric, clinical and molecular determinants of treatment outcomes in postmenopausal, hormone receptor positive metastatic breast cancer patients treated with fulvestrant. Results from a real word setting

L. Pizzuti, C. Natoli, T. Gamucci, M. Mauri, D. Sergi, L. Di Lauro, G. Paoletti, E. Ruggeri, L. Iezzi, I. Sperduti, L. Mentuccia, A. Fabbri, M. Maugeri-Sacca, L. Moscetti, M. Barba, P. Vici

Research output: Contribution to journalArticlepeer-review

Abstract

To characterize determinants of treatment outcome in a real world population of 161 post-menopausal hormone receptor-positive metastatic breast cancer patients treated with fulvestrant. Descriptive statistics for demographics, anthropometrics, clinical and molecular characteristic were compared across subgroups of sensitivity/resistance to prior endocrine therapy and tested in uni/multivariate models. Clinical benefit was more common in sensitive patients with higher estrogen receptor expression and when fulvestrant was given in first line (p=0.02 and 0.046). In resistant patients, PFS was longer with lower BMI (p=0.01). Among endocrine sensitive women, longer PFS was associated with fulvestrant in first-line, single metastasis and no visceral involvement (p=0.01, 0.003 and 0.01). OS was shorter in resistant patients with HER2-positive disease and if fulvestrant was given in second and subsequent line (p=0.03). In sensitive patients, we observed worse OS with multiple metastases (p=0.008). Multivariate analyses confirmed longer PFS in resistant patients with lower BMI and older age (p=0.002 and 0.007). OS in resistant patients was negatively influenced by HER2 positivity and fulvestrant in second and subsequent line (p=0.04). In sensitive women, multiple metastases were associated with poorer survival (p=0.002). This evidence encourages considering patient and disease characteristics in decision making and outcome interpretation for patients candidate to fulvestrant.
Original languageEnglish
Pages (from-to)69025–69037
JournalOncotarget
Volume8
Issue number40
DOIs
Publication statusPublished - Apr 9 2017

Keywords

  • endocrine resistance
  • endocrine sensitivity
  • fulvestrant
  • hormone receptor positive metastatic breast cancer

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