e12003 Background: Irinotecan (I) has some efficacy in taxane (T) and anthracycline (A)-refractory breast cancer, and combination of I and fluoropyrimidine (F) shows synergistic effects in preclinical model. We conducted this study to reveal the clinical outcomes of I and F combination therapy in T, A, and F-pretreated metastatic breast cancer. Methods: We consecutively enrolled metastatic breast cancer patients treated with I and F combination chemotherapy from 2000 to 2008 in Seoul National University Hospital. They all had been previously heavily treated with T, A, and F. We retrospectively analyzed the clinical outcomes. Results: Twenty-five patients were enrolled. The median age was 38 years (range: 30–56years). The performance status was: ECOG 1 (11 patients), 2 (13), and 3 (1). The most commonly involved site was bone (16 patients), liver (13), and lung (12). The biologic subtype was: hormone receptor (+) 17 patients, HER-2 (+) 2, triple-negative (TNBC) 6. The median time from diagnosis of metastatic breast cancer to the initiation of IF therapy was 34 months (range: 12–97 months). The used regimens were: FOLFIRI (18 patients), TS-1/ irinotecan (6), capecitabine/irinotecan (1). Response was evaluable in 24 patients. There was no CR/PR. Stable disease was shown in 29.2% and 70.8% was PD, that is disease control rate was 29.2% (95% CI:10–45%). The median duration of disease control was 3.9 months (95% CI 3.7–4.2, range 2.4–11). The progression-free survival was 1.4 months (95% CI:0.7–21, range: 0.5–11.4), and overall survival was 6 months (95% CI: 4.2–7.8, range: 1–23). According to the biologic subtypes, the median PFS was 2.0 vs. 1.3 months (p=0.895) and OS was 4 vs. 6 months (p=0.807) respectively in TNBC VS Non-TNBC. In multivariate analysis, patients with good PS showed longer OS (p = 0.035). The Gr 3/4 hematologic toxicity was: neutropenia 18.6%, anemia 1.3%, thrombocytopenia 1.3%. And the major Gr 3/4 non-hematologc toxicity was: diarrhea (4%), hand-foot syndrome (0%), fatigue (0%). No treatment-related death was occurred. Conclusions: Treatment of I combined with F might be an option in metastatic breast cancer patients heavily treated with T, A, and F, irrespective of TNBC. Further prospective studies are warranted. No significant financial relationships to disclose.
The impact of waist-to-hip ratio on clinical outcomes in metastatic breast cancer patients treated with aromatase inhibitors
