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Endocrine Therapy for Hormone Receptor-Positive Advanced Breast Cancer: A Nation-Wide Multicenter Epidemiological
1Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Frontiers in Oncology
|March 1, 2021
Summary
In China, less than a quarter of hormone receptor-positive advanced breast cancer patients received endocrine therapy (ET). Multi-line ET showed decreasing effectiveness, highlighting an unmet need for improved treatment options.
Area of Science:
- Oncology
- Endocrinology
- Clinical Epidemiology
Background:
- Clinical guidelines recommend endocrine therapy (ET) for hormone receptor-positive advanced breast cancer (HR+ ABC).
- Real-world adherence to these guidelines for HR+ ABC treatment patterns in China is not well-established.
- Chemotherapy (CT) is typically reserved for life-threatening disease or after limited benefit from sequential ET.
Purpose of the Study:
- To investigate real-world treatment patterns and endocrine therapy (ET) regimens in HR+ ABC patients in China.
- To compare patient characteristics and treatment initiation between ET and CT groups.
- To analyze the utilization and duration of sequential ET lines in HR+ ABC.
Main Methods:
- Retrospective analysis of 2,342 HR+ ABC patients from a nationwide Chinese study (NCT03047889) between January 2012 and December 2014.
- Investigation of clinicopathological characteristics, clinical profiles, and treatment patterns.
- Comparison of patients initiating ET versus CT.
Main Results:
- Only 18.9% of HR+ ABC patients received three lines of ET, with median durations decreasing for each subsequent line (8, 6, and 3 months).
- Patients initiating ET were older, had later recurrence, and less visceral involvement compared to those starting CT.
- Aromatase inhibitor (AI) monotherapy was the primary ET regimen, with limited access to everolimus plus AI combinations.
Conclusions:
- Less than one quarter of HR+ ABC patients initiated palliative ET in Chinese clinical practice.
- Sequential ET lines demonstrated diminishing treatment durations.
- There is a significant unmet need for more effective endocrine therapy options for HR+ ABC in China.
