First-line real-world treatment patterns and survival outcomes in women younger or older than 40 years with metastatic breast cancer in the real-life multicenter French ESME cohort

• Published in: European journal of cancer (1990) Vol. 196; p. 113422
• Main Authors: Galvin, Angéline, Courtinard, Coralie, Bouteiller, Fanny, Gourgou, Sophie, Dalenc, Florence, Jacot, William, Arnedos, Monica, Bailleux, Caroline, Dieras, Véronique, Petit, Thierry, Emile, George, Dubray-Longeras, Pascale, Frenel, Jean-Sébastien, Bachelot, Thomas, Mailliez, Audrey, Brain, Etienne, Desmoulins, Isabelle, Massard, Vincent, Patsouris, Anne, Goncalves, Anthony, Grinda, Thomas, Delaloge, Suzette, Bellera, Carine
• Format: Journal Article
• Language: English
• Published: England 01-01-2024
• Subjects: Adult; Aged; Breast Neoplasms - pathology; Databases, Factual; Female; Humans; Life Sciences; Middle Aged; Progression-Free Survival; Receptor, ErbB-2; Retrospective Studies; Santé publique et épidémiologie; Triple Negative Breast Neoplasms - pathology; Survival endpoints; Metastatic breast cancer; Real-word data
• ISSN: 0959-8049; 1879-0852; 1879-0852
• DOI: 10.1016/j.ejca.2023.113422

To describe first-line treatment patterns, overall survival (OS) and real-world progression-free survival (rwPFS) in young women (<40) with metastatic breast cancer (mBC), as compared to women aged 40-69.
Data on adult women diagnosed with mBC (2008-2017) were extracted from the ESME mBC database (NCT03275311) which includes consecutive patients starting first-line metastatic treatment in one of the 18 French Comprehensive cancer centers. We reported first-line therapeutic strategy and prognostic factors of OS and rwPFS for women aged < 40 and 40-69.
In total, 14,897 mBC women were included (1512 aged <40). HR+ /HER2- mBC was the most frequent subtype. First-line treatment differed between young patients and older ones for HR+ /HER2- and Triple Negative (TN) mBC. Median OS for women aged < 40 and 40-69, respectively, was 46.9 and 46.2 months for HR+ /HER2- mBC; 13.5 and 15.2 for TN mBC; and, 60.7 and 55.1 for HER2 + mBC. Median rwPFS under first line treatment was 11.6 and 11.9 months for HR+ /HER2- in women aged < 40 and 40-69, respectively; 5.5 and 5.9 for TN, and, 13.3 and 12.9 for HER2 + . Factors associated with shorter OS and rwPFS were similar for both women aged < 40 and 40-69 and included ≥ 3 metastatic sites, visceral metastases, and longer MFI, with time-varying effects observed for several prognostic factors.
Young women presented more frequently with TN and HER2 + subtypes and aggressive mBC than women aged 40-69 did. Prognostic factors of OS and rwPFS were quite similar between age groups and mBC subtypes.