artículo
First-line endocrine therapy for advanced breast cancer. A real-world study at a Latin American university health institution
Fecha
2020Registro en:
10.1080/03007995.2020.1763282
1473-4877
0300-7995
MEDLINE:32351137
WOS:000534141800001
Autor
Walbaum, Benjamin
Acevedo, Francisco
Medina, Lidia
Bravo, M. Loreto
Merino, Tomas
Camus, Mauricio
Dominguez, Francisco
Mondaca, Sebastian
Galindo, Hector
Nervi, Bruno
Ibanez, Carolina
Madrid, Jorge
Pena, Jose
Koch, Erica
Garrido, Marcelo
Pinto, Mauricio P.
Sanchez, Cesar
Institución
Resumen
Objective: Clinical guidelines recommend the use of endocrine therapy (ET) in advanced hormone receptor positive (HR+) human epidermal growth factor receptor type 2 negative (HER2-) breast cancer (BC) patients in the absence of visceral disease or ET resistance. Furthermore, studies indicate similar response and survival rates using ET or cytotoxic chemotherapy (CT). Methods: Herein, we assessed clinical characteristics, type of systemic therapy and survival rates of advanced HR + HER2-BC patients in our database. Results: A total of 172 advanced HR + HER2-BC patients were treated at our institution between 1997 and 2019. Sixty percent received first-line ET (4% received combined ET). Median age of this subset was 55 years (range: 30-86). Similarly, the median age of patients that received CT was 54 years (range: 21-83). Over time, 30% of patients received ET in the 2000-2005 period; this increased to 70% in the 2016-2019 period (p = .045). Overall survival (OS) was 97 months and 51 months for patients treated with ET or CT, respectively (p = .002). Conclusions: To the best of our knowledge this is the first study assessing the use of ET in Chilean advanced HR + HER2-BC patients. Several patients in our institution receive CT without indication. The increase in ET usage over time can be attributed to better and faster immunohistochemical detection methods for Estrogen Receptor (ER), changes in educational and government policies, and a wider variety of ET options. Finally, clinical trials have failed to demonstrate a substantial benefit of CT over ET in this setting.