Hormonal therapy followed by chemotherapy or the reverse sequence as first-line treatment of hormone-responsive, human epidermal growth factor receptor-2 negative metastatic breast cancer patients: Results of an observational study

Claudia Bighin, Beatrice Dozin, Francesca Poggio, Marcello Ceppi, Paolo Bruzzi, Alessia D'Alonzo, Alessia Levaggi, Sara Giraudi, Matteo Lambertini, Loredana Miglietta, Marina Vaglica, Vincenzo Fontana, Giuseppina Iacono, Paolo Pronzato, Lucia Del Mastro

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction Although hormonal-therapy is the preferred first-line treatment for hormone-responsive, HER2 negative metastatic breast cancer, no data from clinical trials support the choice between hormonal-therapy and chemotherapy. Methods Patients were divided into two groups according to the treatment: chemotherapy or hormonal-therapy. Outcomes in terms of clinical benefit and median overall survival (OS) were retrospectively evaluated in the two groups. To calculate the time spent in chemotherapy with respect to OS in the two groups, the proportion of patients in chemotherapy relative to those present in either group was computed at every day from the start of therapy. Results From 1999 to 2013, 119 patients received first-line hormonal-therapy (HT-first group) and 100 first-line chemotherapy (CT-first group). Patients in the CTfirst group were younger and with poorer prognostic factors as compared to those in HT-first group. Clinical benefit (77 vs 81%) and median OS (50.7 vs 51.1 months) were similar in the two groups. Time spent in chemotherapy was significantly longer during the first 3 years in CT-first group (54-34%) as compared to the HT-first group (11-18%). This difference decreased after the third year and overall was 28% in the CT-first group and 18% in the HT-first group. Conclusions The sequence first-line chemotherapy followed by hormonal-therapy, as compared with the opposite sequence, is associated with a longer time of OS spent in chemotherapy. However, despite the poorer prognostic factors, patients in the CTfirst group had a superimposable OS than those in the HT-first group.

Original languageEnglish
Pages (from-to)44800-44810
Number of pages11
JournalOncotarget
Volume8
Issue number27
DOIs
Publication statusPublished - 2017

Keywords

  • Advanced breast cancer
  • Chemotherapy
  • First-line treatment
  • Hormonal therapy
  • Hormone-responsive breast cancer

ASJC Scopus subject areas

  • Oncology

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