NEW INSIGHTS INTO HOW FIRST RECURRENCE AT MULTIPLE METASTATIC SITES INFLUENCES SURVIVAL OF PATIENTS WITH HORMONE RECEPTOR-POSITIVE, HER2-NEGATIVE BREAST CANCER: A MULTICENTER STUDY OF 271 RECURRENT METASTATIC PATIENTS

Abstract Background The initial therapeutic strategy for hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer is based on the first metastatic site; however, little evidence is available regarding the influence of metastatic distribution patterns of first metastatic sites on prognosis. In this study, we aimed to identify the metastatic distribution patterns of first metastatic sites that significantly correlate with survival after recurrence. Methods We performed a retrospective review of records from 271 patients with recurrent metastatic HR+/HER2- breast cancer diagnosed between January 2000 and December 2015. We assessed survival after recurrence according to the metastatic distribution patterns of the first metastatic sites and identified significant prognostic factors among patients with single and multiple metastases. Results Prognosis was significantly better in patients with a single metastasis than in those with multiple metastases (median overall survival after recurrence: 5.86 years vs. 2.50 years, respectively, p < 0.001). No metastatic organ site with single metastasis was significantly associated with prognostic outcome, although single metastasis with diffuse lesions was an independent risk factor for worse prognosis (HR: 3.641; 95% CI: 1.856–7.141) and more easily progressing to multiple metastases (p = 0.002). Multiple metastases, including liver metastasis (HR: 3.145; 95% CI: 1.802–5.495) or brain metastasis (HR: 3.289; 95% CI: 1.355–7.937), were regarded as significant independent poor prognostic factors; however, multiple metastases not involving liver or brain metastasis were not significantly related to prognosis after recurrence. Conclusions Single metastases with diffuse lesions could more easily disseminate systemically and progress to multiple metastases, leading to a poor prognosis similar to multiple metastases. Our findings indicate that the reconsideration of the determinant factors of therapeutic strategies for first recurrence in HR+/HER2- breast cancer may be needed.

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Abstract OT1-12-04: A phase IIIb, open-label, local, multicenter study of the molecular features of postmenopausal women with hormone receptor-positive (HR+) HER2-negative advanced breast cancer on first-line treatment with ribociclib and letrozole (BioItaLEE)

10.1158/1538-7445.sabcs18-ot1-12-04 ◽

2019 ◽

Author(s):

M De Laurentiis ◽

G Arpino ◽

G Bianchini ◽

L Malorni ◽

D Castelletti ◽

...

Keyword(s):

Breast Cancer ◽

Multicenter Study ◽

Hormone Receptor ◽

Line Treatment ◽

First Line ◽

Open Label ◽

Molecular Features ◽

Hormone Receptor Positive ◽

Phase Iiib ◽

First Line Treatment

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New insights into patterns of first metastatic sites influencing survival of patients with hormone receptor-positive, HER2-negative breast cancer: a multicenter study of 271 patients

10.21203/rs.3.rs-20043/v1 ◽

2020 ◽

Author(s):

Jun Yamamura ◽

Shunji Kamigaki ◽

Junya Fujita ◽

Hiroki Osato ◽

Hironobu Manabe ◽

...

Keyword(s):

Breast Cancer ◽

Brain Metastasis ◽

Hormone Receptor ◽

Distribution Patterns ◽

Poor Prognostic Factor ◽

Hormone Receptor Positive ◽

Her2 Breast Cancer ◽

Multiple Metastases ◽

Organ Site ◽

Metastatic Sites

Abstract Background: The initial therapeutic strategy for hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer is based on the first metastatic site, but little evidence is available regarding the influence of metastatic distribution patterns of first metastatic sites on prognosis. In this study, we aimed to identify the metastatic distribution patterns of first metastatic sites that significantly correlate with survival after recurrence. Methods: We performed a retrospective review of records from 271 patients with recurrent metastatic HR+/ HER2- breast cancer diagnosed between January 2000 and December 2015. We assessed survival after recurrence according to the metastatic distribution patterns of first metastatic sites and identified significant prognostic factors among the patients with single and multiple metastases. Results: Prognosis was significantly better in patients with single metastasis than those with multiple metastases (median overall survival after recurrence: 5.86 years vs. 2.50 years, p<0.001). No metastatic organ site with single metastasis was significantly associated with prognostic outcome, though single metastasis with diffuse lesions was an independent risk factor for worse prognosis (HR: 3.641; 95% CI: 1.856-7.141), and more easily progressed to multiple metastases (p=0.002). Multiple metastases including liver metastasis (HR: 3.145; 95% CI: 1.802-5.495) or brain metastasis (HR: 3.289; 95% CI: 1.355-7.937) were regarded as a significant independent poor prognostic factor, but multiple metastases not involving liver or brain metastasis were not significantly related to prognosis after recurrence. Conclusions: Single metastasis with diffuse lesions could more easily disseminate systemically and progress to multiple metastases, leading to poor prognosis similar to multiple metastases. The metastatic distribution patterns of first metastatic sites may be important clinical clues for achieving optimal initial treatment for recurrent metastatic HR+/HER2- breast cancer. Our findings indicate that reconsideration of the determinant factors of therapeutic strategies for first recurrence may be needed.

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New insights into patterns of first metastatic sites influencing survival of patients with hormone receptor-positive, HER2-negative breast cancer: a multicenter study of 271 patients

10.21203/rs.3.rs-20043/v2 ◽

2020 ◽

Author(s):

Jun Yamamura ◽

Shunji Kamigaki ◽

Junya Fujita ◽

Hiroki Osato ◽

Hironobu Manabe ◽

...

Keyword(s):

Breast Cancer ◽

Brain Metastasis ◽

Hormone Receptor ◽

Distribution Patterns ◽

Poor Prognostic Factor ◽

Hormone Receptor Positive ◽

Her2 Breast Cancer ◽

Multiple Metastases ◽

Organ Site ◽

Metastatic Sites

Abstract Background: The initial therapeutic strategy for hormone receptor-positive (HR+), HER2-negative (HER2-) breast cancer is based on the first metastatic site, but little evidence is available regarding the influence of metastatic distribution patterns of first metastatic sites on prognosis. In this study, we aimed to identify the metastatic distribution patterns of first metastatic sites that significantly correlate with survival after recurrence.Methods: We performed a retrospective review of records from 271 patients with recurrent metastatic HR+/ HER2- breast cancer diagnosed between January 2000 and December 2015. We assessed survival after recurrence according to the metastatic distribution patterns of first metastatic sites and identified significant prognostic factors among the patients with single and multiple metastases.Results: Prognosis was significantly better in patients with single metastasis than those with multiple metastases (median overall survival after recurrence: 5.86 years vs. 2.50 years, p<0.001). No metastatic organ site with single metastasis was significantly associated with prognostic outcome, though single metastasis with diffuse lesions was an independent risk factor for worse prognosis (HR: 3.641; 95% CI: 1.856-7.141), and more easily progressed to multiple metastases (p=0.002). Multiple metastases including liver metastasis (HR: 3.145; 95% CI: 1.802-5.495) or brain metastasis (HR: 3.289; 95% CI: 1.355-7.937) were regarded as a significant independent poor prognostic factor, but multiple metastases not involving liver or brain metastasis were not significantly related to prognosis after recurrence.Conclusions: Single metastasis with diffuse lesions could more easily disseminate systemically and progress to multiple metastases, leading to poor prognosis similar to multiple metastases. Our findings indicate that reconsideration of the determinant factors of therapeutic strategies for first recurrence in HR+/HER2- breast cancer may be needed.

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Relationship between endocrine resistance and the periods of adjuvant endocrine treatment for hormone receptor-positive, HER2-negative breast cancer

Breast Disease ◽

10.3233/bd-210027 ◽

2021 ◽

pp. 1-6

Author(s):

Jun Yamamura ◽

Yukiko Miyamura ◽

Shunji Kamigaki ◽

Junya Fujita ◽

Hiroki Osato ◽

...

Keyword(s):

Breast Cancer ◽

Hormone Receptor ◽

Endocrine Resistance ◽

Progression Free Survival ◽

Primary Treatment ◽

Endocrine Treatment ◽

First Year ◽

Hormone Receptor Positive ◽

First Recurrence ◽

The Relationship

BACKGROUND: Current guidelines define primary and secondary endocrine resistance according to the periods of adjuvant endocrine therapy (adj-ET); however, the relationship between adj-ET period and endocrine resistance remains unclear. OBJECTIVE: We examined progression-free survival (PFS) after primary ET for recurrent hormone receptor-positive/HER2-negative breast cancer, and evaluated the relationship between endocrine resistance and the periods of adj-ET. METHODS: We assessed PFS among 183 patients who received ET as primary treatment for the first recurrence, according to the period of adj-ET (adj-ET < 1 year, 1–2 years, ≥2 years, and completion). RESULTS: Patients who relapsed during the first year of adj-ET had the significantly shortest PFS. PFS did not significantly differ between patients who relapsed at 1–2 years of adj-ET and patients who relapsed while on adj-ET but after the first 2 years. CONCLUSIONS: Relapse at 1–2 years after adj-ET initiation might be better classified as secondary endocrine resistance rather than primary endocrine resistance.

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