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. 2014 Nov 14:12:344.
doi: 10.1186/1477-7819-12-344.

Factors responsible for long-term survival in metastatic breast cancer

Keiichi Kontani  1 , Shin-ichiro Hashimoto, Chisa Murazawa, Shoko Norimura, Hiroaki Tanaka, Masahiro Ohtani, Naomi Fujiwara-Honjo, Manabu Date, Koji Teramoto, Hitoshi Houchi, Hiroyasu Yokomise
Affiliations

Factors responsible for long-term survival in metastatic breast cancer

Keiichi Kontani et al. World J Surg Oncol. .

Abstract

Background: Although survival of patients with metastatic breast cancer (MBC) has been significantly prolonged over the past decade due to improvement of anti-cancer therapeutics, only a few patients survive for more than 10 years. It has not been determined which patients can have long-term survival with treatment.

Methods: To determine prognostic factors responsible for long-term survival, we retrospectively compared clinicopathologic factors of patients with MBC who survived for 50 months or more after diagnosis with patients who did not. Of 70 patients with MBC who received chemotherapy between November 2005 and September 2011, 23 patients who survived for 50 months or more after diagnosis and 28 patients who died within 50 months after diagnosis were assessed for their clinicopathologic factors and outcomes.

Results: The proportion of patients with hormone receptor-positive (HR+) tumors was significantly higher and the proportion of patients with triple negative tumors (TN) was lower in long-term survivors than in non-long-term survivors (HR+: 87% versus 28.6%, P=0.000037; TN: 13.1% versus 53.6%, P=0.0028). Metastatic site, number of disease sites, prior chemotherapeutic regimens and human epidermal growth factor receptor-2 (HER2) status did not differ between the two groups. The proportion of patients who received metronomic regimens was significantly higher in long-term survivors than in non-long-term survivors (65.2% versus 35.7%, P=0.034) when the most effective regimen among regimens that were received in metastatic settings was compared between the two groups. Overall response rate was significantly higher (82.6% versus 17.9%, P<0.00001) and time to treatment failure after receiving the most effective regimen was longer in long-term survivors than in non-long-term survivors (26 versus 5 months, P=0.0001). The number of chemotherapeutic regimens for breast cancer and that for MBC did not differ between the two groups.

Conclusions: Patients with luminal-type MBC who benefit at least once from chemotherapy including metronomic regimens, or patients who continued to receive the most effective regimen for more than two years can be expected to have long-term survival after diagnosis of MBC, regardless of the number of chemotherapeutic regimens they had received.

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Figures

Figure 1
Figure 1
Comparison of time to treatment failure (TTF) after the most effective regimen in long-term survivors and non-long-term survivors.
Figure 2
Figure 2
Comparison of time to progression (TTP) after the most effective regimen in long-term survivors and non-long-term survivors. PFS in the Figure 2 was changed into TTP.
Figure 3
Figure 3
Comparison of overall survival (OS) after the most effective regimen in long-term survivors and non-long-term survivors.
See this image and copyright information in PMC

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