Efficacy of taxanes rechallenge in first-line treatment of early metastatic relapse of patients with HER2-negative breast cancer previously treated with a (neo)adjuvant taxanes regimen: A multicentre retrospective observational study

Antoine Vasseur, Matthieu Carton, Severine Guiu, Paule Augereau, Lionel Uwer, Marie-Ange Mouret-Reynier, Christelle Levy, Jean-Christophe Eymard, Jean-Marc Ferrero, Marianne Leheurteur, Anthony Goncalves, Marie Robert, Thibault De La Motte Rouge, Thomas Bachelot, Thierry Petit, Marc Debled, Thomas Grinda, Isabelle Desmoulins, Laurence Vanlemmens, Vincent Nicolaï, Gaëtane Simon, Luc Cabel, Antoine Vasseur, Matthieu Carton, Severine Guiu, Paule Augereau, Lionel Uwer, Marie-Ange Mouret-Reynier, Christelle Levy, Jean-Christophe Eymard, Jean-Marc Ferrero, Marianne Leheurteur, Anthony Goncalves, Marie Robert, Thibault De La Motte Rouge, Thomas Bachelot, Thierry Petit, Marc Debled, Thomas Grinda, Isabelle Desmoulins, Laurence Vanlemmens, Vincent Nicolaï, Gaëtane Simon, Luc Cabel

Abstract

Background: Taxanes are one of the most effective chemotherapies (CT) in breast cancer (BC), but the efficacy of taxanes rechallenge in early metastatic relapse has been poorly studied in patients previously treated by taxanes in the (neo)adjuvant setting. Our study aimed to analyse the efficacy of taxane rechallenge in case of early metastatic relapse in a multicentre retrospective observational study compared with other chemotherapies.

Methods: We analysed the French national ESME metastatic BC (MBC) database and selected HER2- MBC patients who received CT in first-line treatment for a metastatic relapse occurring 3-24 months after previous (neo)adjuvant taxanes treatment.

Results: Of 23,501 female patients with MBC in ESME, 1057 met the selection criteria. 58.4% received a taxane-based regimen (75.4% concomitant bevacizumab) and 41.6% received other CT. In hormone-receptor positive (HR+)/HER2- MBC, multivariate analysis showed no difference in OS between taxanes without bevacizumab compared to other CT (HZR = 1.3 [0.97; 1.74], but taxanes was significantly associated with worse PFS (HZR = 1.48 [1.14; 1.93]). In TNBC, taxanes without bevacizumab and carboplatin/gemcitabine were not superior to other CT for OS (HZR = 1.07 [0.79; 1.44] and HZR = 0.81 [0.58; 1.13], respectively), while for PFS, taxanes was inferior (HZR = 1.33 [1.06-1.67]) and carboplatin plus gemcitabine was superior to other CT (HZR = 0.63 [0.46; 0.87]). For both subtypes, the worse outcome observed with paclitaxel was no longer observed with the addition of bevacizumab.

Conclusions: With the limitation of retrospective design, taxanes rechallenge in early metastatic relapse of BC may result in a worse PFS in TNBC and HR+/HER2- MBC, which was not observed with the addition of bevacizumab.

Keywords: Early relapse; Metastatic breast cancer; Rechallenge; Taxanes.

Conflict of interest statement

Declaration of competing interest Marie Robert reports grants from Amgen, Merck, Novartis (travel fees) and Eisai (board member). No other potential conflicts of interest were reported.

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Flow chart. *Including endocrine therapy and CDK4/6 inhibitors. Twenty of these patients were excluded because they received anti-HER-2 therapy. ** Including the combination of taxanes and platinum (carboplatin or cisplatin), CT other than taxanes plus bevacizumab. However, carboplatin plus gemcitabine combination was included in TNBC.
Fig. 2
Fig. 2
OS in patients with HR+/HER2- MBC according to CT regimen: relapse between 3 and 24 months (A), relapse between 3 and 12 months (B), relapse between 12 and 24 months (C).
Fig. 3
Fig. 3
PFS in patients with HR+/HER2- MBC according to CT regimen: relapse between 3 and 24 months (A), relapse between 3 and 12 months (B), relapse between 12 and 24 months (C).
Fig. 4
Fig. 4
OS in patients with TNBC according to CT regimen: relapse between 3 and 24 months (A), relapse between 3 and 12 months (B), relapse between 12 and 24 months (C).
Fig. 5
Fig. 5
PFS in patients with TNBC according to CT regimen: relapse between 3 and 24 months (A), relapse between 3 and 12 months (B), relapse between 12 and 24 months (C).

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