title: Prospective construction and validation of a prognostic score to identify patients who benefit from third-line chemotherapy for metastatic breast cancer in terms of overall survival: the METAL3 Study.
abstract: Metastatic breast cancer (MBC) is an incurable disease and represents a complex therapeutic challenge for oncologists. Despite the possibility of prescribing new agents such as tailored therapy, cytotoxic chemotherapy and hormone therapy remain the major treatments for MBC. Several lines of chemotherapy can be proposed for these patients, but beyond the second-line, evidence of effectiveness is lacking and such treatment has important associated toxicity affecting quality of life (QoL). Prospective data on third-line chemotherapy is very poor. There is no recent retrospective data and it mainly includes single-centre experiences. Moreover, prognostic parameters considered in these retrospective studies are limited to clinico-pathological factors. Previous reports don't evaluate prognostic impact of circulating tumour cells (CTC) and baseline QoL. METAL3 METAstatic Line 3 is a prospective, multicentric trial designed to prospectively construct a prognostic score (including selected clinico-pathological factors, CTC and baseline QoL) to identify patients who benefit from third-line chemotherapy for MBC in terms of overall survival (training cohort). Score will then be validated with another cohort (validation cohort). The aim of this paper is to review literature data on third-line chemotherapy for MBC and to describe in detail our prospective study. We hope that this prognostic score could be used by physicians to develop new therapeutic strategies when there will be limited benefit of third-line chemotherapy; this score will also help to improve patient information on their outcome.
authors.affiliation: Institut Claudius Regaud, Toulouse, France. Electronic address: filleron.thomas@iuct-oncopole.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Filleron
authors.affiliation: Quality of Life in Oncology Platform, Besançon, France; Methodological and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; EA 3181, University of Franche-Comte, Besançon, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Bonnetain
authors.affiliation: Aix Marseille Université, Inserm, IRD, UMR_S912, SESSTIM, Marseille, France; APHMDepartment of Public Health, BiosTIC, Hôpital de la Timone, Marseille, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Mancini
authors.affiliation: Institut Claudius Regaud, Toulouse, France.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Martinez
authors.affiliation: Institut Claudius Regaud, Toulouse, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Roché
authors.affiliation: Institut Claudius Regaud, Toulouse, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Dalenc
mesh_terms: D000367:Age Factors; D000465:Algorithms; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012107:Research Design; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Metastatic breast cancer; Overall survival; Prognostic score; Prospective study; Third line