Evolution of overall survival and receipt of new therapies by subtype among 20 446 metastatic breast cancer patients in the 2008-2017 ESME cohort
T. Grinda
(1)
,
A. Antoine
(2)
,
W. Jacot
(3)
,
C. Blaye
(4)
,
P. H. Cottu
(5)
,
V. Diéras
(6)
,
F. Dalenc
(7)
,
A. Goncalves
(8, 9)
,
M. Debled
(3)
,
A. Patsouris
(10)
,
M. A. Mouret-Reynier
(11)
,
A. Mailliez
(12)
,
F. Clatot
(13)
,
C. Levy
(14)
,
J. M. Ferrero
(15)
,
I. Desmoulins
,
L. Uwer
(16)
,
T. Petit
(17)
,
C. Jouannaud
(18)
,
M. Lacroix-Triki
(1)
,
E. Deluche
,
M. Robain
,
Coralie Courtinard
(19)
,
T. Bachelot
(2)
,
E. Brain
(5)
,
D. Perol
(2)
,
S. Delaloge
(1, 20)
1
IGR -
Institut Gustave Roussy
2 Centre Léon Bérard [Lyon]
3 ICM - Institut régional de Cancérologie de Montpellier
4 Institut Bergonié [Bordeaux]
5 Institut Curie [Paris]
6 CRLCC - CRLCC Eugène Marquis
7 Institut Claudius Regaud
8 IPC - Institut Paoli-Calmettes
9 CRCM - Centre de Recherche en Cancérologie de Marseille
10 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
11 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
12 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
13 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
14 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
15 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 CRLCC Paul Strauss - Centre Paul Strauss
18 Institut Jean Godinot [Reims]
19 BPH - Bordeaux population health
20 Département de médecine oncologique [Gustave Roussy]
2 Centre Léon Bérard [Lyon]
3 ICM - Institut régional de Cancérologie de Montpellier
4 Institut Bergonié [Bordeaux]
5 Institut Curie [Paris]
6 CRLCC - CRLCC Eugène Marquis
7 Institut Claudius Regaud
8 IPC - Institut Paoli-Calmettes
9 CRCM - Centre de Recherche en Cancérologie de Marseille
10 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
11 UNICANCER/CJP - Centre Jean Perrin [Clermont-Ferrand]
12 UNICANCER/Lille - Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
13 CLCC Henri Becquerel - Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
14 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
15 UNICANCER/CAL - Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
16 UNICANCER/ICL - Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
17 CRLCC Paul Strauss - Centre Paul Strauss
18 Institut Jean Godinot [Reims]
19 BPH - Bordeaux population health
20 Département de médecine oncologique [Gustave Roussy]
W. Jacot
- Fonction : Auteur
- PersonId : 761371
- ORCID : 0000-0001-7834-061X
- IdRef : 066771382
P. H. Cottu
- Fonction : Auteur
- PersonId : 775421
- ORCID : 0000-0001-6434-3932
- IdRef : 068862288
A. Goncalves
- Fonction : Auteur
- PersonId : 791165
- ORCID : 0000-0001-7570-7439
- IdRef : 059729481
A. Patsouris
- Fonction : Auteur
- PersonId : 807868
- ORCID : 0000-0001-9101-5424
M. A. Mouret-Reynier
- Fonction : Auteur
- PersonId : 919130
- ORCID : 0000-0001-6981-1678
- IdRef : 142415146
C. Levy
- Fonction : Auteur
- PersonId : 1211445
- ORCID : 0000-0003-0572-5222
- IdRef : 16740301X
I. Desmoulins
- Fonction : Auteur
T. Petit
- Fonction : Auteur
- PersonId : 791590
- ORCID : 0000-0002-7922-9363
- IdRef : 235566365
E. Deluche
- Fonction : Auteur
M. Robain
- Fonction : Auteur
T. Bachelot
- Fonction : Auteur
- PersonId : 757054
- ORCID : 0000-0002-0866-9484
- IdRef : 088209970
S. Delaloge
- Fonction : Auteur
- PersonId : 1144179
- ORCID : 0000-0003-2106-9165
- IdRef : 165172088
Résumé
BACKGROUND: Treatment strategies for metastatic breast cancer (MBC) have made great strides over the past 10 years. Real-world data allow us to evaluate the actual benefit of new treatments. ESME (Epidemio-Strategy-Medico-Economical)-MBC, a nationwide observational cohort (NCT03275311), gathers data of all consecutive MBC patients who initiated their treatment in 18 French Cancer Centres since 2008.
PATIENTS AND METHODS: We evaluated overall survival (OS) in the whole cohort (N = 20 446) and among subtypes: hormone receptor positive, human epidermal growth factor 2 negative (HR+/HER2-; N = 13 590), HER2+ (N = 3919), and triple-negative breast cancer (TNBC; N = 2937). We performed multivariable analyses including year of MBC diagnosis as one of the covariates, to assess the potential OS improvement over time, and we described exposure to newly released drugs at any time during MBC history by year of diagnosis (YOD).
RESULTS: The median follow-up of the whole cohort was 65.5 months (95% CI 64.6-66.7). Year of metastatic diagnosis appears as a strong independent prognostic factor for OS [Year 2016 HR 0.89 (95% CI 0.82-0.97); P = 0.009, using 2008 as reference]. This effect is driven by the HER2+ subcohort, where it is dramatic [Year 2016 HR 0.52 (95% CI 0.42-0.66); P < 0.001, using 2008 as reference]. YOD had, however, no sustained impact on OS among patients with TNBC [Year 2016 HR 0.93 (95% CI 0.77-1.11); P = 0.41, using 2008 as reference] nor among those with HR+/HER2- MBC [Year 2016 HR 1.02 (95% CI 0.91-1.13); P = 0.41, using 2008 as reference]. While exposure to newly released anti-HER2 therapies appeared very high (e.g. >70% of patients received pertuzumab from 2016 onwards), use of everolimus or eribulin was recorded in less than one-third of HR+/HER2- and TNBC cohorts, respectively, whatever YOD.
CONCLUSION: OS has dramatically improved among HER2+ MBC patients, probably in association with the release of several major HER2-directed therapies, whose penetrance was high. This trend was not observed in the other subtypes, but the impact of CDK4/6 inhibitors cannot yet be assessed.
Format du dépôt | Fichier |
---|---|
Type de dépôt | Article dans une revue |
Résumé |
en
BACKGROUND: Treatment strategies for metastatic breast cancer (MBC) have made great strides over the past 10 years. Real-world data allow us to evaluate the actual benefit of new treatments. ESME (Epidemio-Strategy-Medico-Economical)-MBC, a nationwide observational cohort (NCT03275311), gathers data of all consecutive MBC patients who initiated their treatment in 18 French Cancer Centres since 2008.
PATIENTS AND METHODS: We evaluated overall survival (OS) in the whole cohort (N = 20 446) and among subtypes: hormone receptor positive, human epidermal growth factor 2 negative (HR+/HER2-; N = 13 590), HER2+ (N = 3919), and triple-negative breast cancer (TNBC; N = 2937). We performed multivariable analyses including year of MBC diagnosis as one of the covariates, to assess the potential OS improvement over time, and we described exposure to newly released drugs at any time during MBC history by year of diagnosis (YOD).
RESULTS: The median follow-up of the whole cohort was 65.5 months (95% CI 64.6-66.7). Year of metastatic diagnosis appears as a strong independent prognostic factor for OS [Year 2016 HR 0.89 (95% CI 0.82-0.97); P = 0.009, using 2008 as reference]. This effect is driven by the HER2+ subcohort, where it is dramatic [Year 2016 HR 0.52 (95% CI 0.42-0.66); P < 0.001, using 2008 as reference]. YOD had, however, no sustained impact on OS among patients with TNBC [Year 2016 HR 0.93 (95% CI 0.77-1.11); P = 0.41, using 2008 as reference] nor among those with HR+/HER2- MBC [Year 2016 HR 1.02 (95% CI 0.91-1.13); P = 0.41, using 2008 as reference]. While exposure to newly released anti-HER2 therapies appeared very high (e.g. >70% of patients received pertuzumab from 2016 onwards), use of everolimus or eribulin was recorded in less than one-third of HR+/HER2- and TNBC cohorts, respectively, whatever YOD.
CONCLUSION: OS has dramatically improved among HER2+ MBC patients, probably in association with the release of several major HER2-directed therapies, whose penetrance was high. This trend was not observed in the other subtypes, but the impact of CDK4/6 inhibitors cannot yet be assessed.
|
Titre |
en
Evolution of overall survival and receipt of new therapies by subtype among 20 446 metastatic breast cancer patients in the 2008-2017 ESME cohort
|
Auteur(s) |
T. Grinda
1
, A. Antoine
2
, W. Jacot
3
, C. Blaye
4
, P. H. Cottu
5
, V. Diéras
6
, F. Dalenc
7
, A. Goncalves
8, 9
, M. Debled
3
, A. Patsouris
10
, M. A. Mouret-Reynier
11
, A. Mailliez
12
, F. Clatot
13
, C. Levy
14
, J. M. Ferrero
15
, I. Desmoulins
, L. Uwer
16
, T. Petit
17
, C. Jouannaud
18
, M. Lacroix-Triki
1
, E. Deluche
, M. Robain
, Coralie Courtinard
19
, T. Bachelot
2
, E. Brain
5
, D. Perol
2
, S. Delaloge
1, 20
1
IGR -
Institut Gustave Roussy
( 156104 )
- 114, rue Édouard-Vaillant 94805 Villejuif Cedex -France
- France
2
Centre Léon Bérard [Lyon]
( 20549 )
- 28, rue Laennec 69373 LYON Cedex 08
- France
3
ICM -
Institut régional de Cancérologie de Montpellier
( 333482 )
- 124-226 Av. des Apothicaires, 34090 Montpellier
- France
4
Institut Bergonié [Bordeaux]
( 28493 )
- 229, cours de l'Argonne - 33076 Bordeaux
- France
5
Institut Curie [Paris]
( 301888 )
- 26 rue d'Ulm - 75248 Paris
- France
6
CRLCC -
CRLCC Eugène Marquis
( 301510 )
- Avenue Bataille Flandres-Dunkerque 35042 RENNES CEDEX
- France
7
Institut Claudius Regaud
( 300150 )
- France
8
IPC -
Institut Paoli-Calmettes
( 301325 )
- 232 Boulevard de Sainte-Marguerite
13009 Marseille
- France
9
CRCM -
Centre de Recherche en Cancérologie de Marseille
( 179570 )
- 27 bd Leï Roure, BP 300059
13273 Marseille Cedex 09
- France
10
UNICANCER/ICO -
Institut de Cancérologie de l'Ouest [Angers/Nantes]
( 444080 )
- 15, rue André Boquel - 49055 Angers cedex 02
- France
11
UNICANCER/CJP -
Centre Jean Perrin [Clermont-Ferrand]
( 30615 )
- 58 rue Montalembert, 63011 Clermont-Ferrand
- France
12
UNICANCER/Lille -
Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille]
( 301886 )
- 3, rue Frédéric Combemale, 59020 Lille
- France
13
CLCC Henri Becquerel -
Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen
( 353564 )
- Rue d'Amiens CS11516 76038 Rouen Cedex 1
- France
14
UNICANCER/CRLC -
Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
( 301261 )
- 3 avenue général Harris, 14000 Caen
- France
15
UNICANCER/CAL -
Centre de Lutte contre le Cancer Antoine Lacassagne [Nice]
( 123026 )
- 33, avenue de Valombrose, 06189 Nice
- France
16
UNICANCER/ICL -
Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy]
( 357175 )
- 6 avenue de Bourgogne, 54519 Vandoeuvre les Nancy
- France
17
CRLCC Paul Strauss -
Centre Paul Strauss
( 31840 )
- 17 rue Albert Calmette BP 23025 67033 Strasbourg
- France
18
Institut Jean Godinot [Reims]
( 25344 )
- Rue du Général Koenig 51100 Reims
- France
19
BPH -
Bordeaux population health
( 476572 )
- Université de Bordeaux - Case 11 - 146 rue Léo Saignat 33076 Bordeaux cedex
- France
20
Département de médecine oncologique [Gustave Roussy]
( 28519 )
- Gustave Roussy. 114, rue Édouard-Vaillant 94805 Villejuif Cedex -France
- France
|
Vulgarisation |
Non
|
Audience |
Internationale
|
Date de publication |
2021
|
Date de publication électronique |
2021-04-23
|
Licence |
Paternité - Pas d'utilisation commerciale - Pas de modification
|
Langue du document |
Anglais
|
Nom de la revue |
|
Comité de lecture |
Oui
|
Volume |
6
|
Numéro |
3
|
Page/Identifiant |
100114
|
Domaine(s) |
|
Mots-clés |
en
Metastatic breast cancer, Real-life, Overall survival, HER2, New drugs
|
DOI | 10.1016/j.esmoop.2021.100114 |
Origine :
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