HER2-negative metastatic breast cancer patients receiving first-line docetaxel: Survival data and prognostic factors

Abstract

1105 Background: Modern management of metastatic breast cancer (MBC) patients (pts) is currently based on molecular stratification according to HER2 status and first-line taxanes. We sought to examine outcome data and prognostic factors in a prospectively characterized cohort of HER2 negative MBC pts receiving first-line docetaxel in a routine setting. Methods: Medical records from 162 HER2-, MBC pts treated at the Institut Paoli-Calmettes with first-line docetaxel-based regimen between 1997 and 2005 were reviewed. These patients had been treated with docetaxel single-agent or in combination according to standard institutional protocols. Univariate and multivariate analysis according Cox regression model were employed to identify prognostic factors for progression-free survival (PFS) and overall survival (OS). Results: Pt characteristics were the following: median age (ys), 51 (24 -75); Histological type (ductal/lobular/other, %) 81/15/4; Grade (1/2/3, %); Hormonal Receptivity (HR) (yes/no, %) 83/17; Adjuvant chemotherapy (CT) (yes/no; %) 66/34; Disease-free interval (DFI) (<24 months/>24 months, %) 47/53; visceral disease (yes/no, %) 46/54; number of metastatic sites (<3/>3,%) 78/22; liver metastasis (yes/no, %) 31/67; bone metastasis (yes/no, %) 65/35. After a median follow-up of 33 months, median PFS and OS were 11.7 months (95%CI , 9.7 -14.8) and 35 months (95%CI, 28.1–52.1), respectively. By univariate analysis, HR- (p=7.9 e-06), visceral disease (p=0.015), shorter DFI (p=0.027) and previous adjuvant CT (p=0.0038) were negatively associated with PFS, while HR- (p=6.3e-07), visceral disease (p=0.0094) and shorter DFI (p=0.01) were also negatively associated to OS. 14. These parameters retained independent prognostic significance by multivariate analysis, the strongest being HR-(p=2.4e-5) for OS. HR- pts had a PFS of 6.87 months [95%CI, 4.27 - 11.0] Vs 14 months [95%CI, 11.84 - 18.5] in HR+ pts (log-rank test p= 3.16e-06). 2-year OS were 38% [95%CI, 21.9–65] and 76%[95%CI, 68.7–84.4] (p = 6.52e-08) in HR- and HR+ pts, respectively. Conclusions: In the taxane era, median OS of HER2- MBC pts is nearly 3 yrs. Triple negative pts (HER2-, HR-) are a very poor-risk group requiring innovative therapeutic strategies. No significant financial relationships to disclose.