Abstract
Patients with recurrent triple-negative breast cancer (TNBC) currently have no established treatment option other than chemotherapy. However, long-term chemotherapy is often difficult due to adverse effects. A previous study documented a 10%-30% response rate of progestins in oestrogen receptor-negative breast cancer. The aim of this study was to investigate the effect of medroxyprogesterone/megestrol acetate (MPA/MA) in patients with recurrent TNBC. This retrospective observational analysis included 51 patients with recurrent TNBC; 17 were treated with MPA/MA and 34 underwent chemotherapy. The two groups were matched at a 1:2 ratio according to age, metastatic sites, and salvage treatment lines. Efficacy was compared using the χ2 and rank-sum tests. Progression-free survival (PFS) was calculated using the Kaplan-Meier method, and the two groups were compared using the log-rank test. The two groups were well balanced in terms of age, disease-free survival, number of metastases, and salvage therapy lines. Clinical benefit rates in the MPA/MA and chemotherapy groups were 52.94% and 73.53%, respectively (χ2 test, p = 0.208), and median PFS was comparable between groups (log-rank test, p = 0.135). Median PFS of 1st-6th-line salvage treatments was shorter in the MPA/MA group than in the chemotherapy group (log-rank test, p = 0.036), but median PFS of ≥7th-line salvage treatments was comparable (log-rank test, p = 0.139). Eight patients discontinued chemotherapy due to adverse effects, and one patient withdrew from MPA treatment because of weight gain. Progestins (MPA/MA) are an alternative treatment option for multi-treated recurrent TNBC.
Highlights
Tumours without oestrogen receptor (ER), progesterone receptor (PgR), or human epidermal growth factor receptor 2(HER2) expression are referred to as triple-negative breast cancer (TNBC), representing about 15% of all breast cancers [1,2,3,4]
A previous study showed that medroxyprogesterone acetate (MPA) and megestrol acetate (MA) achieved comparable median progression-free survival (PFS) [14], and the two agents were more effective in patients with hormone receptor–positive breast cancer than in those with hormone receptor–negative breast cancer
One case of complete response (CR) and three cases of partial response (PR) were observed in the chemotherapy group, but no such cases were documented in the MPA/MA group
Summary
Tumours without oestrogen receptor (ER), progesterone receptor (PgR), or human epidermal growth factor receptor 2(HER2) expression are referred to as triple-negative breast cancer (TNBC), representing about 15% of all breast cancers [1,2,3,4]. TNBC has an aggressive clinical phenotype with early brain and other distant metastases and a poor prognosis [5,6,7,8,9]. This form of cancer constitutes an important clinical challenge because it is not likely to respond to anti-oestrogen therapy or HER2 antagonists. Selective estrogen response modulators and aromatase inhibitors (AIs) are currently the most commonly used endocrine agents, but such drugs mainly target hormone receptor–positive breast cancers [11, 12]. As TNBC is a relatively newly defined subgroup of breast cancer, older clinical trials did not differentiate breast can-
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