Format

Send to

Choose Destination
Oncotarget. 2017 Apr 9;8(40):69025-69037. doi: 10.18632/oncotarget.16982. eCollection 2017 Sep 15.

Anthropometric, clinical and molecular determinants of treatment outcomes in postmenopausal, hormone receptor positive metastatic breast cancer patients treated with fulvestrant: Results from a real word setting.

Author information

1
Division of Medical Oncology 2, Regina Elena National Cancer Institute, Rome, Italy.
2
Department of Medical, Oral and Biotechnological Sciences, Centro Scienzedell' Invecchiamento e Medicina Traslazionale-CeSI-MeT, Chieti, Italy.
3
Medical Oncology Unit, SS Trinità Hospital, Loc. San Marciano, Sora, Frosinone, Italy.
4
Division of Oncology, San Giovanni Hospital, Rome, Italy.
5
Division of Oncology, Complesso Ospedaliero Belcolle, AUSL Viterbo, Strada S. Martinese, Viterbo, Italy.
6
Biostatistics Unit, Regina Elena National Cancer Institute, Rome, Italy.
7
Scientific Direction, Regina Elena National Cancer Institute, Rome, Italy.
8
Department of Medical and Surgical Sciences for Children and Adults, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.

Abstract

To characterize determinants of treatment outcome in a real world population of 161 post-menopausal hormone receptor-positive metastatic breast cancer patients treated with fulvestrant. Descriptive statistics for demographics, anthropometrics, clinical and molecular characteristic were compared across subgroups of sensitivity/resistance to prior endocrine therapy and tested in uni/multivariate models. Clinical benefit was more common in sensitive patients with higher estrogen receptor expression and when fulvestrant was given in first line (p=0.02 and 0.046). In resistant patients, PFS was longer with lower BMI (p=0.01). Among endocrine sensitive women, longer PFS was associated with fulvestrant in first-line, single metastasis and no visceral involvement (p=0.01, 0.003 and 0.01). OS was shorter in resistant patients with HER2-positive disease and if fulvestrant was given in second and subsequent line (p=0.03). In sensitive patients, we observed worse OS with multiple metastases (p=0.008). Multivariate analyses confirmed longer PFS in resistant patients with lower BMI and older age (p=0.002 and 0.007). OS in resistant patients was negatively influenced by HER2 positivity and fulvestrant in second and subsequent line (p=0.04). In sensitive women, multiple metastases were associated with poorer survival (p=0.002). This evidence encourages considering patient and disease characteristics in decision making and outcome interpretation for patients candidate to fulvestrant.

KEYWORDS:

endocrine resistance; endocrine sensitivity; fulvestrant; hormone receptor positive metastatic breast cancer

Conflict of interest statement

CONFLICTS OF INTEREST Laura Pizzuti declares that she has no conflict of interest. Clara Natoli declares that she has no conflict of interest. Teresa Gamucci declares she has no conflict of interest. Mariella Mauri declares she has conflict of interest. Domenico Sergi declares he has not no conflict of interest. Luigi Di Lauro declares he has no conflict of interest conflict of interest. Giancarlo Paoletti declares he no conflict of interest. Enzo Ruggeri declares he has no conflict of interest. Laura Iezzi declares she has no conflict of interest. Isabella Sperduti declares she has no conflict of interest. Lucia Mentuccia declares she has no conflict of interest. Agnese Fabbri declares she has no conflict of interest. Marcello Maugeri-Saccà declares he has no conflict of interest. Luca Moscetti declares he has no conflict of interest. Maddalena Barba declares she has no conflict of interest. Patrizia Vici declares she has no conflict of interest.

Supplemental Content

Full text links

Icon for Impact Journals, LLC Icon for PubMed Central
Loading ...
Support Center