Evaluation Of First-Line Treatment Outcomes In Metastatic Breast Cancer

Yıl 2025, Cilt: 20 Sayı: 1, 1 - 7

Yaşar Culha , Meltem Baykara , Sena Ece Davarcı , Beyza Ünlü , Duygu Özaşkın , Hacer Demir

https://doi.org/10.17517/ksutfd.1341433

Öz

Objective: Despite the important developments in the treatment of metastatic breast cancer (MBC), especially in the last decade, it continues to be a disease that cannot be cured completely. In our study, we aimed to evaluate the results of first-line treatment in patients with metastatic breast cancer.

Materials and Methods: 263 metastatic breast cancer patients were included in our study. Patient data were analyzed retrospectively.

Results: Median follow-up time is 48.3 months (interquartile range (IQR): 26.5-79.3); De novo metastases were detected in 126 (47.9%) patients, and metastases were detected in 137 (52.1%) patients during follow-up. There was no significant difference in progression-free survival (PFS1) and overall survival (OS) between patient molecular groups according to hormone receptor (HR) and human epidermal growth factor (Her2) status. Still, there was a higher difference in HER2 (+) groups compared to the literatüre, longer OS durations (108 months in the HR- HER2+ group) were detected. A significant PFS1 difference was found between the patient groups according to the first-line treatment categories applied (p=0.01). In PFS1, the longest duration was found in the group that started with chemotherapy and continued with hormone therapy (17.8 months). The shortest duration was found in the group that received only chemotherapy (4.2 months). There was a significant difference in median OS between the groups according to the first-line treatment categories (p=0.025). Pairwise comparisons showed that the difference in OS was due to the group receiving the CDK4/6 inhibitor. Median OS could not be reached in patients with first-line CDK4/6 inhibitor-based hormone therapy.

Conclusion: While there was no difference in overall survival and progression-free survival between patient molecular groups, overall survival time was longer in the HR-HER2+ group and similar in the others when compared to the literature. Median OS could not be reached in those receiving CDK4/6 inhibitors.

Anahtar Kelimeler

Keywords: Breast cancer, metastasis, first-line treatment

Proje Numarası

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Metastatik Meme Kanserinde Birinci Basamak Tedavi Sonuçlarının Değerlendirilmesi

Öz

Amaç: Erken evre meme kanserinde (MK) primer ve adjuvan tedavilerdeki gelişmelere rağmen hala birçok hastada uzak metastaz gelişmektedir. Özellikle son on yılda metastatik meme kanseri (MMK) tedavisinde kaydedilen önemli gelişmelere rağmen tam kür sağlanamayan bir hastalık olmaya devam etmektedir. Çalışmamızda metastatik meme kanserli hastalarda birinci basamak tedavi sonuçlarının değerlendirmeyi amaçladık.
Gereç ve Yöntemler: Çalışmamıza 263 metastatik meme kanseri hastası dâhil edildi. Hasta verileri retrospektif olarak analiz edildi.
Bulgular: Medyan takip süresi 48.3 ay (interquartile range-IQR: 26.5-79.3) olup; 126 (%47.9) hastada de novo metastaz, 137 (%52.1) hastada ise takipte metastaz saptandı. Birinci basamak tedavi sonrası; 39 (%14.8) hastada tam yanıt, 150 (%57) hastada parsiyel yanıt, 6 (%2.3) hastada stabil hastalık ve 35 (%13.3) hastada ise progresif hastalık şeklinde sonuçlandı. Hormon reseptör (HR) ve insan epidermal büyüme faktörü (HER2) durumuna göre hasta moleküler grupları arasında birinci basamak tedavi sonrası progresyonsuz sağ kalım (PFS1) ve genel sağ kalım (OS) sürelerinde anlamlı fark saptanmamıştır ancak HER2 (+) olan gruplarda literatüre kıyasla daha uzun OS süreleri (HR- HER2+ grupta 108 ay) saptandı. Birinci basamakta uygulanan tedavi kategorilerine göre hasta grupları arasında anlamlı bir PFS1 farkı saptanmıştır (p=0.01). PFS1’de en uzun süre kemoterapi ile başlanıp hormonoterapi ile devam edilen grupta (17.8 ay), en kısa süre ise sadece kemoterapi alan grupta saptandı (4.2 ay). Birinci basamak tedavi kategorilerine göre gruplar arasında medyan OS’ de anlamlı fark saptandı (p=0.025). HR+ HER2- olgularda CDK4/6 inhibitörü temelli tedavide diğer tedavilere gör daha OS elde edilmiştir. Birinci basamak CDK4/6 inhibitörü temelli hormonoterapi alanlarda medyan OS’ ye ulaşılamadı.
Sonuç: Hasta moleküler grupları arasında genel sağ kalım ve progresyonsuz sağ kalım farkı saptanmazken, literatür ile kıyaslandığında HR-HER2+ grupta genel sağ kalım süresi daha uzun, diğerlerinde benzerdi. CDK4/6 inhibitörü alanlarda medyan OS’ye ulaşılamamıştır. Birinci basamak tedavilere göre hasta gruplarında PFS1 süreleri literatüre benzer bulunmuştur.

Anahtar Kelimeler

meme kanseri, metastaz, birinci basamak tedavi

Destekleyen Kurum

YOK

Proje Numarası

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Kaynakça

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