Occurrence and characteristics of patients with de novo advanced breast cancer according to patient and tumor characteristics - A retrospective analysis of a real world registry

Abstract

Background: Patients with de novo metastatic breast cancer (dnMBC) may have different clinical and pathological characteristics. In studies concerned with first-line metastatic patients, the proportion of these patients without secondary resistance mechanisms may have a large influence ont the study results. The aim of this study was to identify patient and tumor characteristics that are associated with dnMBC vs. recurrent MBC (rMBC).

Methods: This is a retrospective analysis of data prospectively collected in the PRAEGNANT metastatic breast cancer registry (NCT02338167). Firs line treated patients were eligible. Patient and tumor characteristics were compared with common disease and tumor characteristics relative to de novo metastatic status, as well as early and late recurrences after primary disease without metastases.

Results: Among the 947 patients identified, 355 were included with de novo metastatic disease (37.5%). Older age and HER2-positive disease were significantly associated with a higher frequency of dnMBC. Patients younger than 50, 50-69, or 70 years or older had dnMBC frequencies of 22.7%, 44.0%, and 57.6%, respectively. HER2-positive patients had dnMBC at initial presentation in 49.1% of cases, in comparison with 21.9%, 35.5%, and 37.6% in patients with triple-negative, luminal A-like and luminal B-like breast cancer, respectively.

Conclusion: Age and breast cancer subtype are associated with the frequency of first-line MBC patients. Inclusion criteria concerning age or breast cancer subtype can influence the frequency of these patients in a selected patient population and can therefore modify the number of patients with secondary resistance to specific therapies in clinical trials.

Keywords: Advanced breast cancer; Clinical trials; Recurrent breast cancer metastases; de novo metastatic breast cancer.

Conflict of interest statement

Conflict of interest statement V.M. has received speaker honoraria from Amgen, Astra Zeneca, Daiichi-Sankyo, Eisai, Pfizer, MSD, Novartis, Roche, Teva, Seattle Genetics and consultancy honoraria from Genomic Health, Hexal, Roche, Pierre Fabre, Amgen, ClinSol, Novartis, MSD, Daiichi-Sankyo, Eisai, Lilly, Tesaro and Nektar. A.D.H. has received honoraria from Teva, GenomicHealth, Lilly, AstraZeneca, Novartis, Pfizer, Pierre Fabre, SeaGen and Roche. P.A.F. received honoraria from Novartis, Pfizer, Roche, Amgen, Celgene, Daiichi-Sankyo, AstraZeneca, Merck-Sharp & Dohme, Eisai, Puma and Teva; his institution conducts research with funding from Novartis and Biontech. H.-C.K. has received honoraria from Carl Zeiss meditec, Theraclion, Novartis, Amgen, AstraZeneca, Pfizer, GSK, SurgVision, Onkowissen and Genomic Health/Exact Sciences, travel support from Tesaro and Daiichi Sankyo and holds stock of Theraclion and Phaon scientific. H.T. has received honoraria from Novartis, Roche, Celgene, TEVA, and Pfizer, and travel support from Roche, Celgene, and Pfizer. J.E. has received consulting fees from AstraZeneca, Daiichi Sankyo, Pfizer, Novartis, Lilly, Pierre Fabre, Roche, Tesaro; contracted research from Daiichi Sankyo, Pfizer, Lilly, Novartis, Seattle Genetics, AstraZeneca, Roche, and Odonate; and travel support from Astra Zeneca, Daiichi Sankyo, Celgene, Pfizer, Novartis, Lilly, and Tesaro. D.L. has received honoraria from Novartis, Pfizer, Amgen, Eli Lilly, Teva, Loreal, GSK, MSD, Roche, Astra Zeneca. M.W. received grants from Astra Zeneca, grants from Celgene, grants from Roche, grants from MSD and grants from Novartis during the conduct of the study. E.B. has received honoraria from Novartis, Pfizer, Amgen, Daiichi-Sankyo, and onkowissen.de. P.W. has received honoraria for scientific talks or grants from Amgen, Novartis, MSD, Pfizer, PharmaMar, Teva, Eisai, Clovis and Tesaro. C.H. has received honoraria from Roche Pharma, Pfizer, Astra Zeneca, Novartis, and Onkovis. C.M.K. received honoraria from Amgen, Astra Zeneca, Eli Lilly, MSD Sharp & Dohme, Novartis, Pfizer, Onkotrakt, PharmaMar, Riemser, Roche, Tesaro, Hilotherm, NewCo, research grants from Astra Zeneca, BMS, Immunomedics, MSD Sharp&Dohme (Merck), NewCo, Novartis, Pfizer, PharmaMar, Reimser, Roche, Seattle Genetics and travel support from Amgen, Astra Zeneca, Hexal, Immunomedics, PharmaMar, Pfizer, Tesaro, TEVA Oncology. R.W. has received honoraria from Amgen, Astra Zeneca, Celgene, Daiichi-Sankyo, Esai, Exact Science, Nanostring, GSK, Hexal, Lilly, MSD, Mundipharma, Novartis, Odonate, Pfizer, Pierre Fabre, Riemser, Roche, Sandoz, Seattle Genetics, Tesaro Bio, Teva, and Viatris. M.U. has received honoraria from Abbvie, Amgen, Astra Zeneca, BMS, Celgene, Daiichi-Sankyo, Eisai, Lilly Deutschland, Lilly Int., MSD Merck, Mundipharma, Myriad Genetics, Odonate, Pfizer, PUMA Biotechnology, Roche Pharma, Sanofi Aventis Deutschland, TEVA Pharmaceuticals Ind Ltd, Novartis, Pierre Fabre, Clovis Oncology, and Seattle Genetics. W.J. has received honoraria and research grants from Sanofi-Aventis, Novartis, Lilly, Pfizer, Roche, Chugai, Astra Zeneca, MSD, and Daiichi-Sankyo. F.A.T. has received honoraria from Hexal, Novartis, Tesaro and travel expenses from GSK. M.P.L. has received honoraria from Lilly, Pfizer, Roche, MSD, Hexal, Novartis, AstraZeneca, Eisai, Exact Sciences, Pierre-Fabre, PharmaMar and medac for advisory boards, lectures, and travel support. S.Y.B. has received honoraria from Roche Pharma, Novartis, Pfizer, MSD, Teva, Astra Zeneca. T.N.F. has received honoraria from Novartis, Roche, Pfizer, TEVA, Diachii Sankyo, Astra Zeneca and MSD. All remaining others (A.H., P.H., L.H., M.W.B, S.U., J.M., L.A.W., D.W., L.L.M.) have declared that they do not have any conflicts of interest.

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