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Comparative Study
. 2011;16(2):155-64.
doi: 10.1634/theoncologist.2010-0350. Epub 2011 Jan 25.

Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis

Naoki Niikura  1 , Jun Liu, Naoki Hayashi, Shana L Palla, Yutaka Tokuda, Gabriel N Hortobagyi, Naoto T Ueno, Richard L Theriault
Affiliations
Comparative Study

Treatment outcome and prognostic factors for patients with bone-only metastases of breast cancer: a single-institution retrospective analysis

Naoki Niikura et al. Oncologist. 2011.

Abstract

Purpose: Limited information is available about the optimal management and clinical outcome of bone-only metastases in breast cancer patients. The objective of this study was to define prognostic factors for patients with bone-only metastases. Our second objective was to compare progression-free survival (PFS) and overall survival (OS) between patients with hormone receptor (HR)(+) tumors and bone-only metastases who received combinatory therapy (chemotherapy followed by endocrine therapy, or endocrine therapy combined with molecular targeted therapy) and those treated with endocrine or chemotherapy alone.

Patients and methods: We retrospectively identified 351 breast cancer patients diagnosed with bone-only metastasis in 1997-2008 at our institution.

Results: Patients with metastasis detected at the time of their primary breast cancer diagnosis (rather than at recurrence), a single metastasis, or asymptomatic bone disease had a longer PFS interval, and patients with a performance status of 0-1, a single metastasis, or asymptomatic bone disease had a longer OS time. Among patients with HR(+) human epidermal growth factor receptor (HER)-2(-) disease, combinatory therapy was associated with longer PFS and OS times than with endocrine therapy. In multivariate analyses, combinatory therapy was not associated with longer PFS or OS times than with endocrine therapy. Among patients with HER-2(+) disease, trastuzumab led to a longer PFS interval but no difference in the OS time.

Conclusion: Our results indicate that, for HR(+) disease, a prospective trial of chemotherapy followed by endocrine therapy is warranted to determine whether it prolongs survival more than endocrine therapy alone in patients with bone-only metastases.

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Conflict of interest statement

Disclosures: Naoki Niikura: None; Jun Liu: None; Naoki Hayashi: None; Shana L. Palla: None; Yutaka Tokuda: None; Gabriel N. Hortobagyi: Consultant/advisory role: Allergan, Genentech, Merck, Novartis, sanofi-aventis, Taivex; Research funding/contracted research: Novartis; Naoto T. Ueno: Honoraria: Novartis; Research funding/contracted research: EUSA; Richard L. Theriault: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Figures

Figure 1.
Figure 1.
Kaplan–Meier curves. (A): Progression-free survival by treatment in patients with HR+HER-2− tumors. (B): Overall survival by treatment in patients with HR+HER-2− tumors. (C): Progression-free survival by treatment in patients with HR+HER-2+ tumors. (D): Overall survival by treatment in patients with HR+HER-2+ tumors. Abbreviations: Chemo, chemotherapy; Com, combinatory therapy; End, endocrine therapy; HER-2, human epidermal growth factor receptor 2; HR, hormone receptor.
Figure 2.
Figure 2.
Kaplan–Meier curves of progression-free survival (A) and overall survival (B) for patients with human epidermal growth factor receptor 2–positive tumors by whether they received trastuzumab.
See this image and copyright information in PMC

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