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. 2021 May 28;13(11):2650.
doi: 10.3390/cancers13112650.

Changes in Overall Survival over Time for Patients with de novo Metastatic Breast Cancer

Toshiaki Iwase  1   2 , Tushaar Vishal Shrimanker  1   2 , Ruben Rodriguez-Bautista  1   2 , Onur Sahin  1   2 , Anjali James  1   2 , Jimin Wu  3 , Yu Shen  3 , Naoto T Ueno  1   2
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Changes in Overall Survival over Time for Patients with de novo Metastatic Breast Cancer

Toshiaki Iwase et al. Cancers (Basel). .

Abstract

The purpose of this study was to determine the change in overall survival (OS) for patients with de novo metastatic breast cancer (dnMBC) over time. We conducted a retrospective cohort study with 1981 patients with dnMBC diagnosed between January 1995 and December 2017 at The University of Texas MD Anderson Cancer Center. OS was measured from the date of diagnosis of dnMBC. OS was compared between patients diagnosed during different time periods: 5-year periods and periods defined according to when key agents were approved for clinical use. The median OS was 3.4 years. The 5- and 10-year OS rates improved over time across both types of time periods. A subgroup analysis showed that OS improved significantly over time for the estrogen-receptor-positive/HER2-positive (ER+/HER2+) subtype and exhibited a tendency toward improvement over time for the ER-negative (ER-)/HER2+ subtype. In addition, median OS was significantly longer in patients with non-inflammatory breast cancer (p = 0.02) and patients with ER+ disease, progesterone-receptor-positive disease, HER2+ disease, lower nuclear grade, locoregional therapy, and metastasis to a single organ (all p < 0.0001). These findings showed that OS at 5 and 10 years after diagnosis in patients with dnMBC improved over time. The significant improvements in OS over time for the ER+/HER2+ subtype and the tendency toward improvement for the ER-/HER2+ subtype suggest the contribution of HER2-targeted therapy to survival.

Keywords: breast neoplasms; inflammatory breast neoplasms; neoplasm metastasis; survival analysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Patient selection process.
Figure 2
Figure 2
Overall survival rates for patients with de novo metastatic breast cancer at 1, 2, 5, 10, and 15 years after diagnosis according to diagnosis date, with dates grouped according to (A) the timing of approval of key drugs and (B) 5-year periods.
Figure 3
Figure 3
Overall survival curves for patients with de novo metastatic breast cancer according to year of diagnosis and breast cancer subtype: (A) estrogen receptor positive and HER2 negative (ER+/HER2−); (B) ER+/HER2 positive (HER2+); (C) ER-negative/HER2+; (D) triple-negative breast cancer.
Figure 3
Figure 3
Overall survival curves for patients with de novo metastatic breast cancer according to year of diagnosis and breast cancer subtype: (A) estrogen receptor positive and HER2 negative (ER+/HER2−); (B) ER+/HER2 positive (HER2+); (C) ER-negative/HER2+; (D) triple-negative breast cancer.
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