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Prognostic factors for stage IV hormone receptor-positive primary metastatic breast cancer
Akiko Kawano1, Chikako Shimizu, Kenji Hashimoto
1Breast and Medical Oncology Division , National Cancer Center Hospital, 5-1-1 Tsukiji, Chuou-ku, Tokyo, 104-0045, Japan.
Background:
The purpose of this work was identify potential prognostic factors for survival in patients with primary metastatic hormone receptor-positive breast cancer undergoing endocrine therapy (ET) as first-line treatment.
Methods:
We investigated the clinical and pathological characteristics of 69 newly diagnosed stage IV hormone receptor-positive breast cancer patients undergoing ET between 1999 and 2009, and correlated these factors with disease progression and overall survival.
Results:
Multivariate regression analysis revealed that progesterone receptor (PgR) positivity (hazard ratio (HR) 0.248; p = 0.001) and clinical benefits of first-line ET (HR 0.386; p = 0.008) were significant prognostic factors for survival. When first-line ET was not effective, patients for whom second-line ET was effective survived significantly longer than those for whom second-line ET was not effective (median survival time, 45.3 vs. 25.8 months; p = 0.0411).
Conclusions:
PgR positivity and clinical benefits of first-line ET were independent prognostic factors for patients with hormone receptor-positive stage IV breast cancer. Moreover, the benefits of second-line ET in patients with a tumor resistant to first-line ET suggests the existence of drug-specific resistance to ET.
