Response to second line chemo-endocrine treatment may prolong the overall survival of advanced breast cancer patients.
Prognostic factors and the influence of response to therapy on survival in advanced breast cancer patients remains to be fully elucidated. One hundred and two patients with advanced breast cancer refractory to a combination chemotherapy (FAC) were investigated for response and survival in a randomized trial comparing MMV chemotherapy (mitomycin C, methotrexate, vincristine) alone, or with medroxyprogesterone acetate, or with prednisolone. A total response rate of 28.4% (29/102) was obtained in MMVX. In this second-line chemo-endocrine treatment, univariate and multivariate analyses using 14 clinical factors were performed for response as well as for overall survival of the patients. The logistic regression analysis showed that age, period between recurrence and MMVX, and PS were significant factors for response. According to the Cox's proportional hazard model, factors of PS, period between recurrence and MMVX, dominant site of metastasis and performance of adjuvant therapy were significant for survival. The landmark method (3-month) showed that there was a significant difference in survival by the response category (Kaplan-Meier method with logrank test, p < 0.0001). In the patient population at the landmark time, the Cox model indicated that the response was the most important for survival, but was significantly modified by some factors such as PS. In advanced breast cancer patients treated with a 2nd-line chemo-endocrine treatment, the response to therapy might be a significant determinant for survival of the patients. Prognostic factors for survival should be defined in this stage of malignancy.
Nomura
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Department of Breast Surgery, National Kyushu Cancer Center, Fukuoka, Japan.
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008875:Middle Aged; D015996:Survival Rate