Third-line chemotherapy in metastatic breast cancer: A retrospective institutional assessment about clinical outcomes

Abstract

e17538 Background: Third-line chemotherapy in metastatic breast cancer (MBC) has been evaluated in phase II trials, but there were no prospective randomized studies showing clear benefit forward third-line chemotherapy. However, some patients increased their performance and quality of life despite short survival and low response rate. We analyzed the clinical outcomes in patients using third-line chemotherapy in MBC. Methods: 400 patients using chemotherapy from 2003 to 2007 were evaluated retrospectively. The overall survival (OS) and time to progression (TTP) were assessed with Kaplan-Meier method; the log rank test was applied to correlate known prognostic factors and third-line chemotherapy. Results: 122 patients received third line chemotherapy. The median age was 51 yrs, 89% had IDC histology, 45% had positive hormone receptor, 80% received taxanes or capecitabine as third-line chemotherapy, 88% had PS (ECOG) 0–1 or unknown, 55% had non-visceral metastasis, 89% had been previously exposed to anthracycline or taxanes, and 53% received more than three lines of chemotherapy. The median OS was 8.6 mo (95% CI; 7.5–10.3) and TTP one was 3.6 mo (95% CI; 2.8–4.5); 37% were alive in 1 yr, and the clinical response rate was 19%. TTP more than 8 mo in first- and/or second-line chemotherapy affected TTP in third line (5 vs. 3 mo; p = 0.003); only PS (ECOG) 0–1 resulted better OS (13 vs. 4 mo; p = 0.001). Conclusions: The OS and TTP found are similar to the literature and reflect the poor prognosis in patients receiving third-line chemotherapy in MBC. 8-month cut off TTP in previous lines determine the TTP in third line and good PS results better OS. No significant financial relationships to disclose.