Real-world evidence of the management and prognosis of young women (≤40 years) with de novo metastatic breast cancer

被引：3

作者：

Mallet, Amelie ^{[1
]}

Lusque, Amelie ^{[2
]}

Levy, Christelle ^{[3
]}

Pistilli, Barbara ^{[4
]}

Brain, Etienne ^{[5
]}

Pasquier, David ^{[6
]}

Debled, Marc ^{[7
]}

Thery, Jean Christophe ^{[8
]}

Goncalves, Anthony ^{[9
]}

Desmoulins, Isabelle ^{[10
]}

Rouge, Thibault De La Motte ^{[11
]}

Faure, Christelle ^{[12
]}

Ferrero, Jean Marc ^{[13
]}

Eymard, Jean Christophe ^{[14
]}

Mouret-Reynier, Marie Ange ^{[15
]}

Patsouris, Anne ^{[16
]}

Cottu, Paul ^{[17
]}

Dalenc, Florence ^{[18
]}

Petit, Thierry ^{[19
]}

Payen, Olivier ^{[20
]}

Uwer, Lionel ^{[21
]}

Guiu, Severine ^{[22
]}

Frenel, Jean Sebastien ^{[1
]}

机构：

[1] Inst Cancerol Ouest Rene Gauducheau, Dept Med Oncol, Blvd Jacques Monod, F-44805 St Herblain, France

[2] IUCT Oncopole, Dept Biostat, Inst Claudius Regaud, Toulouse, France

[3] Ctr Francois Baclesse, Dept Med Oncol, Caen, France

[4] Gustave Roussy, Dept Canc Med, Villejuif, France

[5] Inst Curie, Dept Med Oncol, Paris, France

[6] Ctr Oscar Lambret, Dept Radiat Oncol, Lille, France

[7] Inst Bergonie, Dept Med Oncol, Bordeaux, France

[8] Ctr Henri Becquerel, Dept Med Oncol, Rouen, France

[9] Inst Paoli Calmettes, Dept Med Oncol, Marseille, France

[10] Ctr Georges Francois Leclerc, Dept Med Oncol, Dijon, France

[11] Ctr Eugene Marquis, Dept Med Oncol, Rennes, France

[12] Ctr Leon Berard, Dept Surg Oncol, Lyon, France

[13] Ctr Antoine Lacassagne, Dept Med Oncol, Nice, France

[14] Inst Cancerol Jean Godinot, Dept Med Oncol, Reims, France

[15] Ctr Jean Perrin, Dept Med Oncol, Clermont Ferrand, France

[16] Inst Cancerol Ouest Paul Papin, Dept Med Oncol, Angers, France

[17] Etab Hosp Inst Curie, Dept Med Oncol, Paris, France

[18] Inst Claudius Regaud, Dept Med Oncol, IUCT Oncopole, Toulouse, France

[19] Ctr Paul Strauss, Dept Med Oncol, Strasbourg, France

[20] UNICANCER, Data Unit, Dept Real World Data, Paris, France

[21] Inst Cancerol Lorraine, Dept Med Oncol, Vandoeuvre Les Nancy, France

[22] Inst Canc Montpellier, Dept Med Oncol, Montpellier, France

来源：

THERAPEUTIC ADVANCES IN MEDICAL ONCOLOGY | 2022年 / 14卷

关键词：

de novo; metastatic breast cancer; prognosis; real-life; young women; PRIMARY TUMOR; SURVIVAL; METAANALYSIS; GUIDELINES; DOCETAXEL; SURGERY; THERAPY;

D O I：

10.1177/17588359211070362

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available. Methods: We evaluated management of women aged <= 40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41-69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns. Results: Of the 4524 women included, 598 (13%) were <= 40 years. Median age at MBC diagnosis was 36 years (range = 20-40). Compared with women aged 41-69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR-/HER2- disease known as "triple negative breast cancer" (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2- patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0-51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2-, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015). Conclusion: De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

引用

页数：15

共 33 条

[1] Breast Cancer Before Age 40 Years [J].

Anders, Carey K. ;

Johnson, Rebecca ;

Litton, Jennifer ;

Phillips, Marianne ;

Bleyer, Archie .

SEMINARS IN ONCOLOGY, 2009, 36 (03) :237-249

[2] Epidemiology and prognosis of breast cancer in young women [J].

Assi, Hussein A. ;

Khoury, Katia E. ;

Dbouk, Haifa ;

Khalil, Lana E. ;

Mouhieddine, Tarek H. ;

El Saghir, Nagi S. .

JOURNAL OF THORACIC DISEASE, 2013, 5 :S2-S8

[3] Locoregional treatment versus no treatment of the primary tumour in metastatic breast cancer: an open-label randomised controlled trial [J].

Badwe, Rajendra ;

Hawaldar, Rohini ;

Nair, Nita ;

Kaushik, Rucha ;

Parmar, Vani ;

Siddique, Shabina ;

Budrukkar, Ashwini ;

Mittra, Indraneel ;

Gupta, Sudeep .

LANCET ONCOLOGY, 2015, 16 (13) :1380-1388

[4] Pertuzumab plus Trastuzumab plus Docetaxel for Metastatic Breast Cancer [J].

Baselga, Jose ;

Cortes, Javier ;

Kim, Sung-Bae ;

Im, Seock-Ah ;

Hegg, Roberto ;

Im, Young-Hyuck ;

Roman, Laslo ;

Pedrini, Jose Luiz ;

Pienkowski, Tadeusz ;

Knott, Adam ;

Clark, Emma ;

Benyunes, Mark C. ;

Ross, Graham ;

Swain, Sandra M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2012, 366 (02) :109-119

[5] Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (<35 years) with operable breast cancer [J].

Cancello, G. ;

Maisonneuve, P. ;

Rotmensz, N. ;

Viale, G. ;

Mastropasqua, M. G. ;

Pruneri, G. ;

Veronesi, P. ;

Torrisi, R. ;

Montagna, E. ;

Luini, A. ;

Intra, M. ;

Gentilini, O. ;

Ghisini, R. ;

Goldhirsch, A. ;

Colleoni, M. .

ANNALS OF ONCOLOGY, 2010, 21 (10) :1974-1981

[6] 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) [J].

Cardoso, F. ;

Paluch-Shimon, S. ;

Senkus, E. ;

Curigliano, G. ;

Aapro, M. S. ;

Andre, F. ;

Barrios, C. H. ;

Bergh, J. ;

Bhattacharyya, G. S. ;

Biganzoli, L. ;

Boyle, F. ;

Cardoso, M-J ;

Carey, L. A. ;

Cortes, J. ;

El Saghir, N. S. ;

Elzayat, M. ;

Eniu, A. ;

Fallowfield, L. ;

Francis, P. A. ;

Gelmon, K. ;

Gligorov, J. ;

Haidinger, R. ;

Harbeck, N. ;

Hu, X. ;

Kaufman, B. ;

Kaur, R. ;

Kiely, B. E. ;

Kim, S-B ;

Lin, N. U. ;

Mertz, S. A. ;

Neciosup, S. ;

Offersen, B., V ;

Ohno, S. ;

Pagani, O. ;

Prat, A. ;

Penault-Llorca, F. ;

Rugo, H. S. ;

Sledge, G. W. ;

Thomssen, C. ;

Vorobiof, D. A. ;

Wiseman, T. ;

Xu, B. ;

Norton, L. ;

Costa, A. ;

Winer, E. P. .

ANNALS OF ONCOLOGY, 2020, 31 (12) :1623-1649

[7] Triple-negative breast carcinomas are a heterogeneous entity that differs between young and old patients [J].

Carvalho, Filomena M. ;

Bacchi, Livia M. ;

Santos, Priscila P. C. ;

Bacchi, Carlos E. .

CLINICS, 2010, 65 (10) :1033-1036

[8] Effect of Age on Breast Cancer Patient Prognoses: A Population-Based Study Using the SEER 18 Database [J].

Chen, Hai-long ;

Zhou, Mei-qi ;

Tian, Wei ;

Meng, Ke-xin ;

He, Hai-fei .

PLOS ONE, 2016, 11 (10)

[9] Comparison of patterns and prognosis among distant metastatic breast cancer patients by age groups: a SEER population-based analysis [J].

Chen, Meng-Ting ;

Sun, He-Fen ;

Zhao, Yang ;

Fu, Wen-Yan ;

Yang, Li-Peng ;

Gao, Shui-Ping ;

Li, Liang-Dong ;

Jiang, Hong-Lin ;

Jin, Wei .

SCIENTIFIC REPORTS, 2017, 7

[10] Prospective Observational Study of Breast Cancer Treatment Outcomes for UK Women Aged 1840 Years at Diagnosis: The POSH Study [J].

Copson, Ellen ;

Eccles, Bryony ;

Maishman, Tom ;

Gerty, Sue ;

Stanton, Louise ;

Cutress, Ramsey I. ;

Altman, Douglas G. ;

Durcan, Lorraine ;

Simmonds, Peter ;

Lawrence, Gill ;

Jones, Louise ;

Bliss, Judith ;

Eccles, Diana .

JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2013, 105 (13) :978-988

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