Outcomes of metastatic breast cancer patients in relationship to disease-free interval following primary treatment of localized disease; a pooled analysis of two clinical trials
Outcomes of metastatic breast cancer patients in relationship to disease-free interval following primary treatment of localized disease; a pooled analysis of two clinical trials
复制标题
DOI：
10.1111/tbj.13346
复制
发表时间：
2019-09-01
期刊：
影响因子：
2.1
通讯作者：
Abdel-Rahman, Omar
中科院分区：
文献类型：
--
作者：
Abdel-Rahman, Omar
本研究的目的是评估原发性局限性乳腺癌治疗后的无病间期（DFI）对随后接受一线多西他赛化疗的转移性乳腺癌患者结局的影响。本研究是对两项临床试验中604例接受多西他赛一线化疗的转移性乳腺癌患者的患者水平原始数据的合并分析。根据DFI通过Kaplan-Meier分析评价总生存期和至进展时间。然后通过考克斯回归分析对影响总生存期和进展时间的因素进行多变量分析。对于整个队列，较短的DFI与较差的总生存率相关（P < 0.0001）。当按激素受体状态分类时，激素受体阳性和阴性患者中较短的间期与较差的总生存率相关（分别为P = 0.009; P = 0.018）。同样，在整个队列中，较短的DFI与较短的进展时间相关（P < 0.0001）。当按激素受体状态分类时，激素受体阴性而非阳性患者的较短间期与较短的进展时间相关（分别为P = 0.001; P = 0.070）。多因素考克斯回归分析显示，DFI较短（P < 0.0001）、ECOG体力状态评分较低（P = 0.008）和体重指数较低（P = 0.018）与总生存期相关。同样，在多变量考克斯回归分析中，以下因素与较短的进展时间相关：较短的DFI（P < 0.0001）和激素受体阴性状态（P = 0.025）。在接受一线多西他赛化疗的患者中，DFI越短，总生存期越差，至疾病进展时间越短。
The aim of the current study is to assess the impact of disease-free interval (DFI) following treatment of primary localized breast cancer on the outcomes of patients with subsequent metastatic breast cancer treated with first-line docetaxel chemotherapy. This study is a combined analysis of patient-level raw data of 604 metastatic breast cancer patients referred for docetaxel first-line chemotherapy in two clinical trials. Overall survival and time to progression were evaluated according to DFI through Kaplan-Meier analysis. Multivariate analysis of factors affecting overall survival and time to progression was then conducted through Cox regression analysis. For the overall cohort, shorter DFI is associated with worse overall survival (P < 0.0001). When classified by the hormone receptor status, the shorter interval was associated with worse overall survival in both hormone receptor positive and negative patients (P = 0.009; P = 0.018; respectively). Likewise, shorter DFI is associated with shorter time to progression (P < 0.0001) in the overall cohort. When classified by the hormone receptor status, the shorter interval was associated with shorter time to progression for hormone receptor negative but not positive patients (P = 0.001; P = 0.070; respectively). In multivariate Cox regression analysis, the following factors were associated with worse overall survival: shorter DFI (P < 0.0001), poorer ECOG performance score (P = 0.008) and lower body mass index (P = 0.018). Likewise, in multivariate Cox regression analysis, the following factors were associated with shorter time to progression: shorter DFI (P < 0.0001) and hormone receptor negative status (P = 0.025). Shorter DFI was associated with worse overall survival and shorter time to progression among patients receiving first-line docetaxel chemotherapy.