Patterns of Care and Clinical Outcomes of HER2-positive Metastatic Breast Cancer Patients With Newly Diagnosed Stage IV or Recurrent Disease Undergoing First-line Trastuzumab-based Therapy

A Multicenter Retrospective Cohort Study

Matteo Lambertini, Arlindo R. Ferreira, Antonio Di Meglio, Francesca Poggio, Fabio Puglisi, Federico Sottotetti, Filippo Montemurro, Elena Poletto, Antonio Bernardo, Emanuela Risi, Chiara Dellepiane, Valentina Sini, Gabriele Minuti, Donatella Grasso, Sara Fancelli, Lucia Del Mastro

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Abstract

This was a multicenter retrospective cohort study comparing the patterns of care and clinical outcomes of 416 HER2-positive metastatic breast cancer patients with de novo or recurrent disease undergoing first-line trastuzumab-based therapy. Patients with de novo disease showed significantly better survival outcomes than those with recurrent disease. Surgery of the primary breast tumor might play a role in this population. Background The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. Patients and Methods This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. Results From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2%) presented with de novo MBC and 303 (72.8%) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95% confidence interval [CI], 0.43-0.97; P =.035) and for overall survival (OS) of 0.53 (95% CI, 0.30-0.95; P =.034). In the de novo cohort, the 54 patients (47.8%) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95% CI, 0.26-0.72; P =.001) and OS (adjusted HR, 0.49; 95% CI, 0.26-0.93; P =.029) than those who did not undergo surgery. Conclusion Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.

Original languageEnglish
Pages (from-to)601-610.e2
JournalClinical Breast Cancer
Volume17
Issue number8
DOIs
Publication statusPublished - Dec 1 2017

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Cohort Studies
Retrospective Studies
Breast Neoplasms
Survival
Confidence Intervals
Therapeutics
Disease-Free Survival
Trastuzumab
Population
Neoplasms
Recurrence

Keywords

  • Breast carcinoma
  • De novo disease
  • HER2-positivity
  • Metastatic disease
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Patterns of Care and Clinical Outcomes of HER2-positive Metastatic Breast Cancer Patients With Newly Diagnosed Stage IV or Recurrent Disease Undergoing First-line Trastuzumab-based Therapy : A Multicenter Retrospective Cohort Study. / Lambertini, Matteo; Ferreira, Arlindo R.; Di Meglio, Antonio; Poggio, Francesca; Puglisi, Fabio; Sottotetti, Federico; Montemurro, Filippo; Poletto, Elena; Bernardo, Antonio; Risi, Emanuela; Dellepiane, Chiara; Sini, Valentina; Minuti, Gabriele; Grasso, Donatella; Fancelli, Sara; Del Mastro, Lucia.

In: Clinical Breast Cancer, Vol. 17, No. 8, 01.12.2017, p. 601-610.e2.

Research output: Contribution to journalArticle

Lambertini, Matteo ; Ferreira, Arlindo R. ; Di Meglio, Antonio ; Poggio, Francesca ; Puglisi, Fabio ; Sottotetti, Federico ; Montemurro, Filippo ; Poletto, Elena ; Bernardo, Antonio ; Risi, Emanuela ; Dellepiane, Chiara ; Sini, Valentina ; Minuti, Gabriele ; Grasso, Donatella ; Fancelli, Sara ; Del Mastro, Lucia. / Patterns of Care and Clinical Outcomes of HER2-positive Metastatic Breast Cancer Patients With Newly Diagnosed Stage IV or Recurrent Disease Undergoing First-line Trastuzumab-based Therapy : A Multicenter Retrospective Cohort Study. In: Clinical Breast Cancer. 2017 ; Vol. 17, No. 8. pp. 601-610.e2.
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title = "Patterns of Care and Clinical Outcomes of HER2-positive Metastatic Breast Cancer Patients With Newly Diagnosed Stage IV or Recurrent Disease Undergoing First-line Trastuzumab-based Therapy: A Multicenter Retrospective Cohort Study",
abstract = "This was a multicenter retrospective cohort study comparing the patterns of care and clinical outcomes of 416 HER2-positive metastatic breast cancer patients with de novo or recurrent disease undergoing first-line trastuzumab-based therapy. Patients with de novo disease showed significantly better survival outcomes than those with recurrent disease. Surgery of the primary breast tumor might play a role in this population. Background The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. Patients and Methods This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. Results From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2{\%}) presented with de novo MBC and 303 (72.8{\%}) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95{\%} confidence interval [CI], 0.43-0.97; P =.035) and for overall survival (OS) of 0.53 (95{\%} CI, 0.30-0.95; P =.034). In the de novo cohort, the 54 patients (47.8{\%}) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95{\%} CI, 0.26-0.72; P =.001) and OS (adjusted HR, 0.49; 95{\%} CI, 0.26-0.93; P =.029) than those who did not undergo surgery. Conclusion Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.",
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T1 - Patterns of Care and Clinical Outcomes of HER2-positive Metastatic Breast Cancer Patients With Newly Diagnosed Stage IV or Recurrent Disease Undergoing First-line Trastuzumab-based Therapy

T2 - A Multicenter Retrospective Cohort Study

AU - Lambertini, Matteo

AU - Ferreira, Arlindo R.

AU - Di Meglio, Antonio

AU - Poggio, Francesca

AU - Puglisi, Fabio

AU - Sottotetti, Federico

AU - Montemurro, Filippo

AU - Poletto, Elena

AU - Bernardo, Antonio

AU - Risi, Emanuela

AU - Dellepiane, Chiara

AU - Sini, Valentina

AU - Minuti, Gabriele

AU - Grasso, Donatella

AU - Fancelli, Sara

AU - Del Mastro, Lucia

PY - 2017/12/1

Y1 - 2017/12/1

N2 - This was a multicenter retrospective cohort study comparing the patterns of care and clinical outcomes of 416 HER2-positive metastatic breast cancer patients with de novo or recurrent disease undergoing first-line trastuzumab-based therapy. Patients with de novo disease showed significantly better survival outcomes than those with recurrent disease. Surgery of the primary breast tumor might play a role in this population. Background The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. Patients and Methods This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. Results From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2%) presented with de novo MBC and 303 (72.8%) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95% confidence interval [CI], 0.43-0.97; P =.035) and for overall survival (OS) of 0.53 (95% CI, 0.30-0.95; P =.034). In the de novo cohort, the 54 patients (47.8%) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95% CI, 0.26-0.72; P =.001) and OS (adjusted HR, 0.49; 95% CI, 0.26-0.93; P =.029) than those who did not undergo surgery. Conclusion Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.

AB - This was a multicenter retrospective cohort study comparing the patterns of care and clinical outcomes of 416 HER2-positive metastatic breast cancer patients with de novo or recurrent disease undergoing first-line trastuzumab-based therapy. Patients with de novo disease showed significantly better survival outcomes than those with recurrent disease. Surgery of the primary breast tumor might play a role in this population. Background The aim of the study was to compare the patterns of care and clinical outcomes of HER2-positive metastatic breast cancer (MBC) patients with de novo or recurrent disease who underwent first-line trastuzumab-based therapy. Patients and Methods This was a multicenter retrospective cohort study including consecutive patients with HER2-positive MBC who received first-line trastuzumab-based therapy. Analyses on treatment response and effectiveness were conducted according to type of metastatic presentation (ie, de novo vs. recurrent disease). Exploratory analyses were used to evaluate whether the use of surgery of the primary tumor in the de novo cohort influenced patients' survival. Results From January 2000 to December 2013, 416 patients were included in the study, 113 (27.2%) presented with de novo MBC and 303 (72.8%) with recurrent disease. Compared with patients in the recurrence cohort, those in the de novo cohort had worse baseline characteristics, received more aggressive first-line treatments, and showed better survival, with an adjusted hazard ratio (HR) for progression-free survival (PFS) of 0.65 (95% confidence interval [CI], 0.43-0.97; P =.035) and for overall survival (OS) of 0.53 (95% CI, 0.30-0.95; P =.034). In the de novo cohort, the 54 patients (47.8%) who underwent surgery of the primary tumor had significantly better PFS (adjusted HR, 0.44; 95% CI, 0.26-0.72; P =.001) and OS (adjusted HR, 0.49; 95% CI, 0.26-0.93; P =.029) than those who did not undergo surgery. Conclusion Patients with de novo HER2-positive MBC showed significantly better survival outcomes than those with recurrent disease. In this population, surgery of the primary breast tumor was associated with better outcomes.

KW - Breast carcinoma

KW - De novo disease

KW - HER2-positivity

KW - Metastatic disease

KW - Surgery

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DO - 10.1016/j.clbc.2017.04.002

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