title: Everolimus in Metastatic Breast Cancer: Clinical Experience as a Late Treatment Line.
abstract: BACKGROUND
  Everolimus (Afinitor®) plus exemestane are indicated for hormone receptor-positive, HER2/neu-negative metastatic breast cancer (MBC), in menopausal women without symptomatic visceral disease after recurrence or progression following aromatase inhibitors. But everolimus efficacy as late treatment has not been explored.
  
  
  METHODS
  Sixty-three MBC patients progressing under hormonotherapy (HT; n = 30) or after chemotherapy (CT; n = 32) received everolimus plus HT (EHT) and were analyzed for safety, efficacy and overall survival (OS). This cohort was compared with our previous 530 MBC patients stratified by line (PMID 21852136).
  
  
  RESULTS
  The median duration of EHT was 27.8 weeks at 5-10 mg/day until clinical progression or toxicity. Median OS was not reached (median follow-up 18 months). Twelve-month survival was 100, 79 and 49% for patients treated with 0 (n = 13), 1-2 (n = 18) and >3 CT (n = 32), respectively. Median time-to-treatment failure was 6.4 months. In 62 EHT patients randomly matched 1:7 with 421 previous patients for age and number of CT, OS improved compared with patients receiving a new CT (p = 0.062). In patients pretreated with <2 CT, EHT gave a better OS than in those with a new CT (p = 0.026).
  
  
  CONCLUSIONS
  These results may support the use of EHT whatever the number of previous lines.
authors.affiliation: Centre Jean Perrin, Clermont-Ferrand, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Pouget
authors.forename: Catherine
authors.initials: C
authors.lastname: Abrial
authors.forename: Eloise
authors.initials: E
authors.lastname: Planchat
authors.forename: Isabelle
authors.initials: I
authors.lastname: Van Praagh
authors.forename: Marie
authors.initials: M
authors.lastname: Arbre
authors.forename: Fabrice
authors.initials: F
authors.lastname: Kwiatkowski
authors.forename: Pascale
authors.initials: P
authors.lastname: Dubray-Longeras
authors.forename: Hervé
authors.initials: H
authors.lastname: Devaud
authors.forename: Joyce
authors.initials: J
authors.lastname: Dohou
authors.forename: Pauline
authors.initials: P
authors.lastname: Herviou
authors.forename: Hakim
authors.initials: H
authors.lastname: Mahammedi
authors.forename: Xavier
authors.initials: X
authors.lastname: Durando
authors.forename: Philippe
authors.initials: P
authors.lastname: Chollet
authors.forename: Marie-Ange
authors.initials: MA
authors.lastname: Mouret-Reynier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000730:Androstadienes / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D016022:Case-Control Studies; D004958:Estradiol / Q000008:administration & dosage / Q000031:analogs & derivatives; D000068338:Everolimus / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D000077267:Fulvestrant; D006801:Humans; D000077289:Letrozole; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009570:Nitriles / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013629:Tamoxifen / Q000008:administration & dosage; D014230:Triazoles / Q000008:administration & dosage
chemical_list: D000730:Androstadienes; D009570:Nitriles; D014230:Triazoles; D013629:Tamoxifen; D000077267:Fulvestrant; D004958:Estradiol; D000077289:Letrozole; D000068338:Everolimus; C056516:exemestane