Neoadjuvant therapy for breast cancer has no benefits on overall survival or on the mastectomy rate in routine clinical practice. A population-based study with a median follow-up of 11years using propensity score matching

2012 ◽  
Vol 48 (15) ◽  
pp. 2300-2310 ◽  
Author(s):  
I. Le Ray ◽  
S. Dabakuyo ◽  
G. Crehange ◽  
M. Bardou ◽  
L. Arnould ◽  
...  
2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1125-1125 ◽  
Author(s):  
L. Cortesi ◽  
C. Cirilli ◽  
I. Rashid ◽  
E. Artioli ◽  
M. Federico

1125 Background: A significant improvement in overall survival was observed in the last two decades in patients with breast cancer due to early diagnosis and more effective therapies. However, a significant improvement in metastatic setting has been questioned. Our population based study was aimed to investigate the outcome of metastatic breast cancer from 1988 to 2005. Methods: Women with stage IV de novo or relapsed breast cancer diagnosed between 1988 and 2005 were identified by the Modena Cancer Registry (MCR). For all patients overall survival (OS) was measured from the date of first distant metastases to the date of death from any cause or last follow-up and compared across groups for four periods of similar duration time: 1988–1993 (A), 1994–1997(B), 1998–2001(C), 2002–2005(D). Results: Among 8,654 patients with breast cancer identified by the MCR, 409 had an initial metastatic disease (4.8%) and 693 (8.4%) had a distant recurrence. Median age at onset was 66 versus 59 years in de novo vs relapsed disease (p = 0.001). Significant differences for postmenopausal age (80% vs 71%) and for positive estrogen receptors (72% vs 63%) were registered in de novo and relapsed disease, respectively (p = 0.001). After a 27 months median follow-up for initial metastatic disease, the five-year OS was 12%, 14%, 9%, and 13% in the A, B, C, and D periods, respectively, (p = 0.5). Conversely, in relapsed breast cancer, after a 29 months median follow-up, a significant survival improvement was observed between the first and the other three periods, being the 5 year-survival rate after recurrence 10%, 22%, 30%, and 25%, respectively (p = 0.001). A survival improvement was seen in the last ten years for relapsed breast cancer using aromatase inhibitors (p < 0.0001) while for initial metastatic disease the same treatment provided a better outcome only in the last 4 years (p < 0.0001). Conclusions: Data from our study show that the outcome of initial metastatic breast cancer is still discouraging, despite the availability of several new drugs in recent years. A limited improvement was observed in relapsed breast cancer with the aromatase inhibitors introduction. In any case, the finish line is still far away, and robust investments in basic and translational research are still absolutely necessary. No significant financial relationships to disclose.


2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13024-e13024
Author(s):  
Hassan Errihani ◽  
Narjiss Berrada ◽  
Mouna Khouchani ◽  
Abdelkader Acharki ◽  
Kamal Lahbabi ◽  
...  

e13024 Background: Hertraz, the first trastuzumab biosimilar was approved in Morocco in 2017. Real world data on trastuzumab biosimilars are very limited or not available. HERLife is a prospective, non-interventional phase IV study program that investigated the experience of using Hertraz, a biosimilar for trastuzumab (Herceptin), under routine clinical practice conditions in Morocco. The primary aim of this study was to confirm the acceptable safety and tolerability of Hertraz. Methods: Ninety-nine patients with HER2-positive breast cancer treated with Hertraz were enrolled from 8 public and private sector hospitals and followed up for 12 months as part of this non-interventional study. Cardiac events (LVEF) and other unexpected or serious adverse events were monitored. The study arms consisted of patients with early breast cancer (Arm 1, n=70) and metastatic breast cancer (Arm 2, n=29) whose median age was 53 years in both groups. Results: Switching from Herceptin to Hertraz was observed in 45% of 29 MBC patients and 27% of 70 EBC patients. Switching was done at a median of 4th cycle. Pertuzumab was used in combination with Hertraz in 69% and 19% of patients in the metastatic and neoadjuvant settings, respectively. Two patients had a decline in LVEF. One patient treated with Hertraz alone and one patient treated with Hertraz and pertuzumab developed a decrease in LVEF requiring a three-week treatment discontinuation of Hertraz. Treatment of Hertraz was continued after 1 skipped cycle without occurrence of new side effects. No other trastuzumab related adverse events was observed. Four patients in the metastatic group and 2 patients in the early breast cancer arm had a relapse in the 12 months of clinical follow-up. Conclusions: The management of HER2+ breast cancer in Morocco follows the international recommendations. This is the first real world safety data of Hertraz from Morocco. The 12-month follow-up treatment with Hertraz showed an acceptable cardiac safety profile. In cases where there was a switch from Herceptin to Hertraz or Hertraz combined with pertuzumab, the safety profile was similar to that previously reported in other studies.


2000 ◽  
Vol 18 (15) ◽  
pp. 2836-2842 ◽  
Author(s):  
Gilles Chaplain ◽  
Chantal Milan ◽  
Catherine Sgro ◽  
Paule-Marie Carli ◽  
Claire Bonithon-Kopp

PURPOSE: To quantify the risk of acute leukemia after adjuvant therapy, especially chemotherapy with topoisomerase II inhibitors. PATIENTS AND METHODS: We performed a population-based study in a cohort of 3,093 women younger than 85 years who resided in the French administrative area of the Côte d’Or, who were given a first diagnosis of primary breast cancer between 1982 and 1996, and who received a curative treatment. Information about therapy and follow-up events was obtained from records of cancer registries that covered this area. RESULTS: Until December 1998, 10 cases of acute leukemia, including nonlymphoid acute leukemia and refractory anemia with excess of blasts, occurred in patients before any local or distant recurrence. All cases developed in the first 4 years of follow-up. Compared with the general female population, the incidence rate of leukemia was significantly increased in women who received radiotherapy and chemotherapy (standardized incidence ratio, 28.5; P < .0001). A dose-dependent increase in the risk of leukemia was observed in women treated with mitoxantrone. Cox regression analysis showed that the risk of leukemia was significantly lower in patients treated with anthracyclines than in those treated with mitoxantrone at cumulative doses ≥ 13 mg/m2. CONCLUSION: The combination of adjuvant radiotherapy and chemotherapy with mitoxantrone induces a high risk of acute leukemia in patients with breast cancer. A leukemogenic effect of chemotherapy with anthracyclines cannot be ruled out with certainty. However, there are some suggestions that these topoisomerase II inhibitors might be less leukemogenic than mitoxantrone and could be preferred in an adjuvant setting.


2005 ◽  
Vol 23 (33) ◽  
pp. 8305-8312 ◽  
Author(s):  
Mélanie Drolet ◽  
Elizabeth Maunsell ◽  
Jacques Brisson ◽  
Chantal Brisson ◽  
Benoît Mâsse ◽  
...  

Purpose Little is known about factors increasing likelihood of not working among breast cancer survivors compared with women in the general population. Patients and Methods A population-based retrospective cohort study was conducted in Quebec, Canada, based on the consecutive series of working women aged younger than 60 years when first treated for breast cancer (identified through the Quebec Tumor Registry), and on a group of randomly selected similar women, living in Quebec, who were working at the time of survivors' diagnoses, but who were without cancer (identified through provincial health care files). Data came from a telephone interview, 3 years after diagnosis for 646 survivors (73% of those eligible) or during a similar period for 890 comparison women (51%). Results Slightly more survivors were not working 3 years after diagnosis compared with women never diagnosed with cancer (21% and 15%, respectively). Older age (for survivors and comparison women, relative risk [RR] = 4.62, P < .0001 and RR = 4.98, P < .0001, respectively) and union membership (RR = 1.88, P = .0003 and RR = 1.40, P = .06, respectively) increased the likelihood of not working at the end of follow-up. In addition, income less than $20,000 compared with ≥ $50,000 was associated with not working only among survivors (RR = 3.18; P = .0008). Adjuvant treatments did not predict work cessation, but any new cancer event during follow-up did (RR = 2.14; P < .0001). Conclusion Although reassuring that adjuvant treatments did not appear to play a role in survivors' not working, other aspects of the cancer experience might nonetheless have influenced the decision to reduce work effort after breast cancer.


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