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Measures of outcome in metastatic breast cancer: insights from a real-world scenario.
- Source :
-
The oncologist [Oncologist] 2014 Jun; Vol. 19 (6), pp. 608-15. Date of Electronic Publication: 2014 May 02. - Publication Year :
- 2014
-
Abstract
- No gold standard treatment exists for metastatic breast cancer (MBC). Clinical decision making is based on knowledge of prognostic and predictive factors that are extrapolated from clinical trials and, sometimes, are not reliably transferable to a real-world scenario. Moreover, misalignment between endpoints used in drug development and measures of outcome in clinical practice has been noted. The roles of overall survival (OS) and progression-free survival (PFS) as primary endpoints in the context of clinical trials are the subjects of lively debate. Information about these parameters in routine clinical practice is potentially useful to design new studies and/or to interpret the results of clinical research. This study analyzed the impact of patient and tumor characteristics on the major measures of outcome across different lines of treatment in a cohort of 472 patients treated for MBC. OS, PFS, and postprogression survival (PPS) were analyzed. The study showed how biological and clinical characteristics may have different prognostic value across different lines of therapy for MBC. After first-line treatment, the median PPS of luminal A, luminal B, and human epidermal growth factor receptor 2 (HER2)-positive groups was longer than 12 months. The choice of OS as a primary endpoint for clinical trials could not be appropriate with these subtypes. In contrast, OS could be an appropriate endpoint when PPS is expected to be low (e.g., triple-negative subtype after the first line; other subtypes after the third line). The potential implications of these findings are clinical and methodological.<br /> (©AlphaMed Press.)
- Subjects :
- Adult
Aged
Clinical Trials as Topic
Disease-Free Survival
Female
Humans
Middle Aged
Neoplasm Metastasis
Receptor, ErbB-2 genetics
Triple Negative Breast Neoplasms epidemiology
Triple Negative Breast Neoplasms pathology
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Treatment Outcome
Triple Negative Breast Neoplasms drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1549-490X
- Volume :
- 19
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The oncologist
- Publication Type :
- Academic Journal
- Accession number :
- 24794159
- Full Text :
- https://doi.org/10.1634/theoncologist.2014-0002