METHODS: We analysed the French national ESME metastatic BC (MBC) database and selected HER2- MBC patients who received CT in first-line treatment for a metastatic relapse occurring 3-24 months after previous (neo)adjuvant taxanes treatment.
RESULTS: Of 23,501 female patients with MBC in ESME, 1057 met the selection criteria. 58.4% received a taxane-based regimen (75.4% concomitant bevacizumab) and 41.6% received other CT. In hormone-receptor positive (HR+)/HER2- MBC, multivariate analysis showed no difference in OS between taxanes without bevacizumab compared to other CT (HZR = 1.3 [0.97; 1.74], but taxanes was significantly associated with worse PFS (HZR = 1.48 [1.14; 1.93]). In TNBC, taxanes without bevacizumab and carboplatin/gemcitabine were not superior to other CT for OS (HZR = 1.07 [0.79; 1.44] and HZR = 0.81 [0.58; 1.13], respectively), while for PFS, taxanes was inferior (HZR = 1.33 [1.06-1.67]) and carboplatin plus gemcitabine was superior to other CT (HZR = 0.63 [0.46; 0.87]). For both subtypes, the worse outcome observed with paclitaxel was no longer observed with the addition of bevacizumab.
CONCLUSIONS: With the limitation of retrospective design, taxanes rechallenge in early metastatic relapse of BC may result in a worse PFS in TNBC and HR+/HER2- MBC, which was not observed with the addition of bevacizumab.
方法:我们分析了法国国家ESME转移性BC(MBC)数据库,并选择了HER2-MBC患者,这些患者在一线治疗中接受了CT治疗,在先前(新)辅助紫杉烷治疗后3-24个月发生转移性复发。
结果:在23,501例ESME患者中,1057符合选择标准。58.4%接受了基于紫杉烷的方案(75.4%合并贝伐单抗),41.6%接受了其他CT。在激素受体阳性(HR+)/HER2-MBC中,多变量分析显示,与其他CT相比,没有贝伐单抗的紫杉烷类之间的OS没有差异(HZR=1.3[0.97;1.74],但紫杉烷与较差的PFS显著相关(HZR=1.48[1.14;1.93])。在TNBC,没有贝伐单抗和卡铂/吉西他滨的紫杉烷类药物在OS方面不优于其他CT(HZR=1.07[0.79;1.44]和HZR=0.81[0.58;1.13],分别),而对于PFS,紫杉烷类次品(HZR=1.33[1.06-1.67]),卡铂+吉西他滨优于其他CT(HZR=0.63[0.46;0.87]).对于这两个子类型,在添加贝伐单抗的情况下,不再观察到紫杉醇的不良结局.
结论:由于回顾性设计的局限性,紫杉烷类药物在早期转移性BC复发中的再攻击可能导致TNBC和HR/HER2-MBC的PFS恶化,这在添加贝伐单抗时未观察到。