Comparison of the Efficacy between First-Line Treatment Regimens for Patients with Hormone Receptor-Positive and HER2-Negative Metastatic Breast Cancer
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Purpose: Endocrine therapy is the first-line treatment recommended for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer without visceral crisis. However, this recommendation has not been followed clinically because of efficacy issues. In this study, the survival of patients with HR-positive/HER2-negative metastatic breast cancer was evaluated based on the following first-line treatment regimens: the combination of palbociclib plus letrozole, conventional endocrine therapy, or chemotherapy. Methods: Medical records were reviewed for this retrospective analysis. Patients with HR-positive/HER2-negative metastatic breast cancer were included. Progression-free survival (PFS) and overall survival (OS) were compared based on first-line treatment regimens. Results: A total of 184 patients were included in the analysis. The first-line treatments were palbociclib plus letrozole in 46 patients (25.0%), endocrine therapy in 40 patients (21.7%), and chemotherapy in 98 patients (53.3%). The PFS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=3.43, p<0.001) and chemotherapy (hazard ratio=2.88, p=0.001) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.430). The OS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=5.34, p=0.009) and chemotherapy (hazard ratio 4.23, p=0.043) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.451). Conclusion: The combination regimen of palbociclib and letrozole could be recommended as the first-line treatment of choice in patients with HR-positive/HER2-negative metastatic breast cancer.
Abstract
Purpose: Endocrine therapy is the first-line treatment recommended for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer without visceral crisis. However, this recommendation has not been followed clinically because of efficacy issues. In this study, the survival of patients with HR-positive/HER2-negative metastatic breast cancer was evaluated based on the following first-line treatment regimens: the combination of palbociclib plus letrozole, conventional endocrine therapy, or chemotherapy. Methods: Medical records were reviewed for this retrospective analysis. Patients with HR-positive/HER2-negative metastatic breast cancer were included. Progression-free survival (PFS) and overall survival (OS) were compared based on first-line treatment regimens. Results: A total of 184 patients were included in the analysis. The first-line treatments were palbociclib plus letrozole in 46 patients (25.0%), endocrine therapy in 40 patients (21.7%), and chemotherapy in 98 patients (53.3%). The PFS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=3.43, p<0.001) and chemotherapy (hazard ratio=2.88, p=0.001) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.430). The OS of the palbociclib plus letrozole group was significantly longer than that of the endocrine therapy (hazard ratio=5.34, p=0.009) and chemotherapy (hazard ratio 4.23, p=0.043) groups. No significant difference was observed between the endocrine therapy and chemotherapy groups (p=0.451). Conclusion: The combination regimen of palbociclib and letrozole could be recommended as the first-line treatment of choice in patients with HR-positive/HER2-negative metastatic breast cancer.
참고문헌 (15)
- Jacquet E, "Endocrine therapy or chemotherapy as first-line therapy in hormone receptor-positive HER2-negative metastatic breast cancer patients", Eur J Cancer, 95, pp.93~101 (2018)
- Rugo HS, "Endocrine therapy for hormone receptor-positive metastatic breast cancer : American Society of Clinical Oncology Guideline", J Clin Oncol, 34, pp.3069~3103 (2016)
- Paluch-Shimon S, "Prevention and screening in BRCA mutation carriers and other breast", ovarian hereditary cancer syndromes : ESMO Clinical Practice Guidelines for cancer prevention and screening, 2016, pp.27, v103~10
- Gradishar WJ, "Breast cancer, version 3.2020, NCCN Clinical Practice Guidelines in Oncology", J Natl Compr Canc Netw, 18, pp.452~478 (2020)
- Swallow E, "Real-world patterns of endocrine therapy for metastatic hormone-receptor-positive(HR+)", human epidermal growth factor receptor-2-negative(HER2-)breast cancer patients in the United States : 2002-2012, 2014, pp.30, 1537~1545
- Fietz T, "Palliative systemic therapy and overall survival of 1, 395 patients with advanced breast cancer-results from the prospective German TMK cohort study", Breast, 34, pp.122~130 (2017)
- Rugo HS, "Palbociclib plus letrozole as first-line therapy in estrogen receptor-positive", human epidermal growth factor receptor 2-negative advanced breast cancer with extended follow-up, 2019, pp.174, 719~729
- Rossi V, "Should all patients with HR-positive HER2-negative metastatic breast cancer receive CDK 4", 6 inhibitor as first-line based therapy? A network meta-analysis of data from the PALOMA 2, MONALEESA 2, MONALEESA 7, MONARCH 3, FALCON, SWOG and FACT trials, 2019, pp.11, 1661~
- Im SA, "Palbociclib plus letrozole as first-line therapy in postmenopausal Asian women with metastatic breast cancer : results from the phase III, randomized PALOMA-2 study", J Glob Oncol, 5, pp.1~19 (2019)
- Finn RS, "The cyclin-dependent kinase 4", 6 inhibitor palbociclib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer(PALOMA-1, Lancet Oncol, pp.2015, 16[DOI]
- Husinka L, "Review of cyclin-dependent kinase 4", 6 inhibitors in the treatment of advanced or metastatic breast cancer, 2021, pp.10, 27~34
- Cardoso F, "3rd ESO-ESMO international consensus guidelines for advanced breast cancer(ABC 3)", Breast, 31, pp.244~259 (2017)
- Finn RS, "Palbociclib and letrozole in advanced breast ancer", N Engl J Med, 375, pp.1925~1936 (2016)
- DeMichele A, "Comparative effectiveness of first-line palbociclib plus letrozole versus letrozole alone for HR+", HER2-metastatic breast cancer in US real-world clinical practice, 2021, pp.23, 37~
- 노영훈, "전신치료 후 장기간 종양의 유지를 보이는 전이성 유방암 환자의 임상적 특징", Journal of Breast Disease, 5(1), pp.1~7 (2017), 한국유방암학회[DOI]