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Experimental Hematology & Oncology

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Open Access 01-12-2015 | Research

Clinical outcomes among HR+/HER2− metastatic breast cancer patients with multiple metastatic sites: a chart review study in the US

Authors: Jipan Xie, Yanni Hao, Nanxin Li, Peggy L. Lin, Erika Ohashi, Valerie Koo, Eric Q. Wu

Published in: Experimental Hematology & Oncology | Issue 1/2015

Abstract

Background

Hormone receptor-positive, human epidermal growth factor receptor-2-negative (HR+/HER2−) is the most common type of metastatic breast cancer (mBC). While mBC patients generally have poor prognosis with limited progression-free survival (PFS) and overall survival (OS), those with multiple metastatic sites may have even worse clinical outcomes due to multiple organ involvement. This study aimed to compare clinical outcomes including PFS, time on treatment (TOT), and OS between HR+/HER2− mBC patients with multiple metastases versus those with a single metastasis in a real-world clinical setting.

Methods

This was a retrospective chart review study of postmenopausal HR+/HER2− mBC women who had failed a non-steroidal aromatase inhibitor in the adjuvant or metastatic setting and initiated a new treatment for mBC between 07/01/2012 and 04/15/2013. Patients were classified to one of two study groups (multiple metastases or single metastasis) based on the number of non-lymph-node metastases at the initiation of the new treatment. PFS, TOT and OS were compared between the two groups using Kaplan–Meier analyses and multivariable Cox proportional hazard models adjusting for patient disease and treatment characteristics. Separate Cox models were conducted including models with an interaction term between line of therapy and study group to assess the impact of multiple metastases on clinical outcomes across different lines of therapy.

Results

A total of 699 patient charts were collected, including 291 patients with multiple metastases and 408 single metastasis patients. Worse performance status and a higher proportion of prior chemotherapy for mBC were observed among patients with multiple metastases. Overall, patients with multiple metastases had significantly shorter PFS [adjusted hazard ratio (HR) = 1.55, 95 % confidence interval (CI) 1.21–1.98], TOT (adjusted HR = 1.33, 95 % CI 1.05–1.67), and OS (adjusted HR = 1.77, 95 % CI 1.15–2.74) than single metastasis patients. Similar outcomes were observed in each line of therapy.

Conclusions

Among HR+/HER2− mBC patients, patients with multiple metastases had significantly shorter PFS, TOT, and OS than single metastasis patients, highlighting the substantial clinical burden and unmet need for more efficacious treatments for the former group of patients.

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Title: Clinical outcomes among HR+/HER2− metastatic breast cancer patients with multiple metastatic sites: a chart review study in the US
Authors: Jipan Xie
Yanni Hao
Nanxin Li
Peggy L. Lin
Erika Ohashi
Valerie Koo
Eric Q. Wu
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Experimental Hematology & Oncology / Issue 1/2015
Electronic ISSN: 2162-3619
DOI: https://doi.org/10.1186/s40164-015-0023-0

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