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Thijssen S, Wildiers H, Punie K, Beuselinck B, Clement P, Remmerie C, Berteloot P, Han S, Van Nieuwenhuysen E, Van Gorp T, Vergote I, Smeets A, Nevelsteen I, Floris G, Weltens C, Menten J, Janssen H, Laenen A, Neven P. Features of durable response and treatment efficacy for capecitabine monotherapy in advanced breast cancer: real-world evidence from a large single-centre cohort. J Cancer Res Clin Oncol 2021; 147:1041-1048. [PMID: 33471187 DOI: 10.1007/s00432-020-03487-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/27/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE In metastatic breast cancer (MBC) population treated with capecitabine monotherapy, we investigated clinical-pathological features as possible biomarkers for the oncological outcome. METHODS Retrospective study of consecutive MBC patients treated at University Hospitals Leuven starting capecitabine between 1999 and 2017. The primary endpoint was the durable response (DR), defined as non-progressive disease for > 52 weeks. Other main endpoints were objective response rate (ORR), time to progression (TTP) and overall survival (OS). RESULTS We included 506 patients; mean age at primary breast cancer diagnosis was 51.2 years; 18.2% had de novo MBC; 98.8% were pre-treated with taxanes and/or anthracycline. DR was reached in 11.6%. Patients with DR, as compared to those without DR, were more likely oestrogen receptor (ER) positive (91.5% vs. 76.8%, p = 0.010) at first diagnosis, had a lower incidence of lymph node (LN) involvement (35.6% vs. 49.9%, p = 0.039) before starting capecitabine, were more likely to present with metastases limited to ≤ 2 involved sites (54.2% vs. 38.5%, p = 0.020) and time from metastasis to start of capecitabine was longer (mean 3.5 vs. 2.7 years, p = 0.020). ORR was 22%. Median TTP and OS were 28 and 58 weeks, respectively. In multivariate analysis (only performed for TTP), ER positivity (hazard ratio (HR) = 0.529, p < 0.0001), HER2 negativity (HR = 0.582, p = 0.024), absence of LN (HR = 0.751, p = 0.008) and liver involvement (HR = 0.746, p = 0.013), older age at capecitabine start (HR = 0.925, p < 0.0001) and younger age at diagnosis of MBC (HR = 0.935, p = 0.001) were significant features of longer TTP. CONCLUSION Our data display relevant clinical-pathological features associated with DR and TTP in patients receiving capecitabine monotherapy for MBC.
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Affiliation(s)
- S Thijssen
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - H Wildiers
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - K Punie
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - B Beuselinck
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - P Clement
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - C Remmerie
- Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - P Berteloot
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - S Han
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - E Van Nieuwenhuysen
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - T Van Gorp
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - I Vergote
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - A Smeets
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - I Nevelsteen
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - G Floris
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - C Weltens
- Department of Radiotherapy, University Hospitals Leuven, Leuven, Belgium
| | - J Menten
- Department of Radiotherapy, University Hospitals Leuven, Leuven, Belgium
| | - H Janssen
- Department of Radiotherapy, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Department of Biostatistics, University Hospitals Leuven, Leuven, Belgium
| | - P Neven
- Department of Gynecological Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
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