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Sirieix J, Fraisse J, Mathoulin-Pelissier S, Leheurteur M, Vanlemmens L, Jouannaud C, Diéras V, Lévy C, Ung M, Mouret-Reynier MA, Petit T, Coudert B, Brain E, Pistilli B, Ferrero JM, Goncalves A, Uwer L, Patsouris A, Tredan O, Courtinard C, Gourgou S, Frénel JS. Management and outcome of male metastatic breast cancer in the national multicenter observational research program Epidemiological Strategy and Medical Economics (ESME). Ther Adv Med Oncol 2021; 12:1758835920980548. [PMID: 33488779 PMCID: PMC7768846 DOI: 10.1177/1758835920980548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022] Open
Abstract
Background and Aims: Because of its low prevalence, metastatic breast cancer (MBC) in males is managed based on clinical experience with women. Using a real-life database, we aim to provide a comprehensive analysis of male MBC characteristics, management and outcome. Methods: The Epidemiological Strategy and Medical Economics Data Platform collected data for all men and women ⩾18 years with MBC in 18 participating French Comprehensive Cancer Centers from January 2008 to November 2016. Demographic, clinical, and pathological characteristics were retrieved, as was treatment modality. Men were matched 1:1 to women with similar characteristics. Results: Of 16,701 evaluable patients, 149 (0.89%) men were identified. These men were older (median age 69 years) and predominantly had hormone receptor HR+/HER2– disease (78.3%). Median overall survival (OS) was 41.8 months [95% confidence interval (CI: 26.9–49.7)] and similar to women. Median progression-free survival (PFS) with first-line therapy was 9.3 months [95% CI (7.4–11.5)]. In the HR+/HER2– subpopulation, endocrine therapy (ET) alone was the frontline treatment for 43% of patients, including antiestrogens (n = 19), aromatase inhibitors (n = 15) with luteinizing hormone-releasing hormone (LHRH) analogs (n = 3), and various sequential treatments. Median PFS achieved by frontline ET alone was similar in men [9.8 months, 95% CI (6.9–17.4)] and in women [13 months, 95% CI (8.4–30.9)] (p = 0.80). PFS was similar for HR+/HER2– men receiving upfront ET or chemotherapy: 9.8 months [95% CI (6.9–17.4)] versus 9.5 months [95% CI (7.4–11.7)] (p = 0.22), respectively. Conclusion: MBC management in men and women leads to similar outcomes, especially in HR+/HER2– patients for whom ET should also be a cornerstone. Unsolved questions remain and successfully recruiting trials for men are still lacking.
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Affiliation(s)
- Junien Sirieix
- Department of Medical Oncology, ICO Institut de Cancerologie de l'Ouest - René Gauducheau, Saint-Herblain, France
| | - Julien Fraisse
- Biometrics Unit, ICM Regional Cancer Institute of Montpellier, Montpellier, France
| | - Simone Mathoulin-Pelissier
- Bordeaux University, Inserm CIC1401 and Clinical and Epidemiological Research Unit, Institut Bergonie, Bordeaux, France
| | | | | | | | - Véronique Diéras
- Department of Medical Oncology, Centre Eugene Marquis, Rennes, France
| | - Christelle Lévy
- Department of Medical Oncology, Centre Francois Baclesse, Caen, France
| | - Mony Ung
- Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France
| | | | - Thierry Petit
- Department of Medical Oncology, GINECO & Paul Strauss Cancer Center and University of Strasbourg, Strasbourg, France
| | - Bruno Coudert
- Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Barbara Pistilli
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
| | - Jean-Marc Ferrero
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Anthony Goncalves
- Department of Medical Oncology, Institute Paoli-Calmettes, Marseille, France
| | - Lionel Uwer
- Department of Medical Oncology, Institut de Cancérologie de Lorraine - Alexis Vautrin, Vandoeuvre-Lès-Nancy, France
| | - Anne Patsouris
- Department of Medical Oncology, ICO Institut de Cancerologie de l'Ouest - Paul Papin, Angers, France
| | - Olivier Tredan
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | | | - Sophie Gourgou
- Biometrics Unit, ICM Regional Cancer Institute of Montpellier, Montpellier, France
| | - Jean-Sébastien Frénel
- Department of Medical Oncology, ICO Institut de Cancerologie de l'Ouest - René Gauducheau, Saint-Herblain, France
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