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Twelves C, Cortes J, Kaufman PA, Yelle L, Awada A, Binder TA, Olivo M, Song J, O'Shaughnessy JA, Jove M, Perez EA. "New" metastases are associated with a poorer prognosis than growth of pre-existing metastases in patients with metastatic breast cancer treated with chemotherapy. Breast Cancer Res 2015; 17:150. [PMID: 27391598 PMCID: PMC4674925 DOI: 10.1186/s13058-015-0657-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 11/19/2015] [Indexed: 12/15/2022] Open
Abstract
Introduction Progression-free survival (PFS) and overall survival (OS) endpoints often only weakly correlate. This analysis investigates how different progression events impact on OS, using data from two phase 3 studies with eribulin in women with advanced/metastatic breast cancer (MBC). Methods In Study 301, 1102 women with ≤2 prior chemotherapies for advanced/MBC were randomized to eribulin mesylate (1.4 mg/m2 on days 1 and 8 every 21 days) or capecitabine (1.25 g/m2 twice daily on days 1–14 every 21 days). Study 305/EMBRACE enrolled 762 patients following two to five prior chemotherapies for advanced/MBC, randomized to eribulin (as above) or treatment of physician’s choice. We analyzed OS and PFS post hoc for patients whose disease progressed due to development of “new” metastases, growth of pre-existing lesions, and patients with no reported disease progression. Results In both clinical studies, development of new metastases was associated with an increased risk of death (p < 0.0001). The time to development of new metastasis or death was significantly longer with eribulin than the comparator in Study 305 (p = 0.0017), but not in Study 301 (p = 0.46). Significantly longer OS was observed in the eribulin compared with the comparator arm for the new metastases subgroup in Study 301 (p = 0.008), but not in Study 305 (p = 0.16), compared with other progression subgroups. Conclusions Patients with MBC progressing with new metastases have a worse prognosis than those whose disease progresses due to growth of existing lesions or patients with no reported disease progression. These findings have potentially important implications for the interpretation of clinical study data and clinical practice. Trial registration ClinicalTrials.gov registration IDs: Study 301: NCT00337103; Study 305: NCT00388726.
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Affiliation(s)
- Christopher Twelves
- Section of Oncology and Clinical Research, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK. .,St James' Institute of Oncology, St James' University Hospital, University of Leeds, Bexley Wing, Level 4, Beckett Street, Leeds, UK.
| | - Javier Cortes
- Department of Oncology, Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Department of Oncology, Ramon y Cajal University Hospital, Madrid, Spain
| | - Peter A Kaufman
- Section of Hematology/Oncology, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Louise Yelle
- Department of Medicine, University of Montreal, Montreal, QC, Canada
| | - Ahmad Awada
- Medical Oncology Clinic, Medicine Department, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Martin Olivo
- Oncology PCU, Clinical Development, Eisai Inc., Woodcliff Lake, NJ, USA
| | - James Song
- Department of Medical Affairs, Eisai Inc., Woodcliff Lake, NJ, USA
| | - Joyce A O'Shaughnessy
- Department of Medical Oncology, US Oncology, Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX, USA
| | - Maria Jove
- Section of Oncology and Clinical Research, Leeds Institute of Cancer and Pathology, University of Leeds and Leeds Teaching Hospitals Trust, Leeds, UK
| | - Edith A Perez
- Division of Hematology/Oncology, Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
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