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. 2021 Jan 21:13:1758835920987657.
doi: 10.1177/1758835920987657. eCollection 2021.

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program

Marion Bertho  1 , Julien Fraisse  2 , Anne Patsouris  1 , Paul Cottu  3 , Monica Arnedos  4 , David Pérol  5 , Anne Jaffré  6 , Anthony Goncalves  7 , Marie-Paule Lebitasy  8 , Véronique D'Hondt  9 , Florence Dalenc  10 , Jean-Marc Ferrero  11 , Christelle Levy  12 , Sandrine Dabakuyo  13 , Roman Rouzier  14 , Frédérique Penault-Llorca  15 , Lionel Uwer  16 , Jean-Christophe Eymard  17 , Mathias Breton  18 , Michaël Chevrot  19 , Sébastien Thureau  20 , Thierry Petit  21 , Gaëtane Simon  19 , Jean-Sébastien Frénel  22
Affiliations

Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program

Marion Bertho et al. Ther Adv Med Oncol. .

Abstract

Background: Bone-only (BO) metastatic breast cancer (MBC) is considered a more favorable entity than other MBC presentations. However, only few retrospective series and data from selected randomized controlled trials have been reported so far.

Methods: Using the French national multicenter ESME (Epidemiological Strategy and Medico Economics) Data Platform, the primary objective of our study was to compare the overall survival (OS) of patients with BO versus non-BO MBC at diagnosis, with adjustment on main prognostic factors using a propensity score. Secondary objectives were to compare first-line progression-free survival (PFS1), describe treatment patterns, and estimate factors associated with OS.

Results: Out of 20,095 eligible women, 5041 (22.4%) patients had BO disease [hormone-receptor positive (HR+)/human epidermal growth-factor-receptor-2 negative (HER2-), n = 4 102/13,229 (31%); HER2+, n = 644/3909 (16.5%); HR-/HER2-, n = 295/2 957 (10%)]. BO MBC patients had a better adjusted OS compared with non-BO MBC [52.1 months (95% confidence interval (CI) 50.3-54.1) versus 34.7 months (95% CI 34.0-35.6) respectively]. The 5-year OS rate of BO MBC patients was 43.4% (95% CI 41.7-45.2). They also had a better PFS1 [13.1 months (95% CI 12.6-13.8) versus 8.5 months (95% CI 8.3-8.7), respectively]. This observation could be repeated in all subtypes. BO disease was an independent prognostic factor of OS [hazard ratio 0.68 (95% CI 0.65-0.72), p < 0.0001]. Results were concordant in all analyses.

Conclusion: BO MBC patients have better outcomes compared with non-BO MBC, consistently, through all MBC subtypes.

Keywords: bone-only; metastatic breast cancer; outcomes; overall survival; real-life; treatments.

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Conflict of interest statement

Conflict of interest statement: P Cottu reports grants from Pfizer and Novartis, personal fees from Pfizer and Eli-Lilly, and non-financial support from Pfizer, outside the submitted work. M Arnedos reports research grants from Eli-Lilly, consultant fees from Novartis, Astra Zeneca, Pfizer and Seattle Genetics, outside the submitted work. D Pérol reports personal fees from Roche, Pierre Fabre, Novartis, BMS, Eli-Lilly, Ipsen, MSD, personal fees and non-financial support from Astra Zeneca, grants from MDS, outside the submitted work. A Goncalves reports non-financial support from Astra Zeneca, Pfizer, Roche and Novartis, outside the submitted work. F Penault-Llorca reports non-financial support from Astra Zeneca, Pfizer, Novartis, Roche, and Eli-Lilly, outside the submitted work. JS Frénel reports personal fees from Roche, Astra Zeneca, Lilly, Pfizer, Novartis, GSK, and ESAI and non-financial support from Roche, Astra Zeneca, Pfizer, and Novartis, outside the submitted work. All other authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
Study flowchart. BO, bone only; ESME, Epidemiological Strategy and Medico Economics; HER2, human epidermal growth-factor-receptor 2; HR, hormonal receptor; MBC, metastatic breast cancer.
Figure 2.
Figure 2.
Adjusted Kaplan–Meier curves of overall survival (OS) in the overall population and in each tumor subtype group by location of metastatic disease. (a) Overall population; (b) HR+/HER2− cohort; (c) HER2+ cohort; (d) HR−/HER2− cohort. BO, bone only; HER2, human epidermal growth-factor-receptor 2; HR, hormone receptor.
Figure 3.
Figure 3.
Adjusted Kaplan–Meier curves of first-line progression-free survival (PFS1) in the overall population and in each tumor subtype group by location of metastatic disease. (a) Overall population; (b) HR+/HER2− cohort; (c) HER2+ cohort; (d) HR−/HER2− cohort. BO, bone only; HER2, human epidermal growth-factor-receptor 2; HR, hormone receptor.
See this image and copyright information in PMC

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