We assessed the use and outcomes of first-, second- and third-line chemotherapy in patients diagnosed with hormone receptor-positive/HER2-negative (HR+/HER2-) advanced breast cancer (ABC).
All consecutively diagnosed patients with HR+/HER2-ABC in 2007-2020 in ten Dutch hospitals were retrieved from the SONABRE registry (NCT-03577197). Last follow-up was collected in 2022. The proportion of patients starting a specific line of chemotherapy was assessed using the competing risk method. Median progression-free survival (PFS) and overall survival (OS) were calculated from start of chemotherapy using the Kaplan-Meier method.
Of the 3146 patients diagnosed with HR+/HER2-ABC, 54% started a first-, 32% a second- and 18% a third-line of chemotherapy within 120 months from diagnosis, regardless of prior endocrine-based therapy. At start of first-, second- and third-line of chemotherapy, median age was respectively 63, 61 and 60 years, 73%, 78% and 71% had a WHO performance status of 0-1, 48%, 51% and 47% received chemotherapy in the (neo)adjuvant setting, and 80%, 88% and 91% had visceral metastases. When chemotherapy started in 2014-2022, first-, second- and third-line chemotherapy comprised capecitabine in respectively 54%, 35% and 19%, taxanes in 29%, 34% and 24%, and an AC-containing regimen in 12%, 6% and 5% of patients. Median PFS and OS were 6.7 and 15.9 months from starting first-line, 4.9 and 10.5 months from starting second-line and 3.9 and 8.2 months from starting third-line chemotherapy.
Patients diagnosed with HR+/HER2-ABC with an indication for chemotherapy have advanced disease and a poor prognosis. Capecitabine and taxanes were most often used in the first three lines of chemotherapy.
The authors.
The SONABRE Registry is supported by Novartis BV; Roche; Pfizer; Eli Lilly & Co.; Daiichi Sankyo; Gilead and AstraZeneca. Funding sources had no role in the conceptualization or writing of the abstract.
S.M.E. Geurts: Financial Interests, Institutional, Funding: Novartis BV, Roche, Pfizer, Ely Lilly, Daiichi Sankyo, Gilead, AstraZeneca; Financial Interests, Personal, Invited Speaker: AstraZeneca. M. Meegdes: Financial Interests, Institutional, Funding: Novartis BV, Roche, Pfizer, Eli Lilly, Daiichi Sankyo, Gilead, AstraZeneca. A. Fallois: Financial Interests, Institutional, Funding: Novartis BV, Roche, Pfizer, Eli Lilly, Daiichi Sankyo, Gilead. I.J.H. Vriens: Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Research Grant: Pfizer. V.C.G. Tjan-Heijnen: Financial Interests, Personal, Advisory Board: E Lilly, AstraZeneca, Novartis; Financial Interests, Institutional, Research Grant: E Lilly, Novartis, Pfizer, AstraZeneca, Roche, Gilead. All other authors have declared no conflicts of interest.