Secondary analyses of the randomized phase III Stop&Go study : efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer
Background: Previously, we showed that reintroduction of the same (first-line) chemotherapy at progression could only partially make up for the loss in efficacy as compared to continuously delivered first-line chemotherapy. Here, we report the probability of starting second-line study chemotherapy in the Stop&Go trial, and the progression-free survival (PFS) and overall survival (OS) of patients who received both the first- and second-line treatment in an intermittent versus continuous schedule.Methods: First-line chemotherapy comprised paclitaxel plus bevacizumab, second-line capecitabine or non-pegylated liposomal doxorubicin, given per treatment line as two times four cycles (intermittent) or as eight consecutive cycles (continuous).Results: Of the 420 patients who started first-line treatment within the Stop&Go trial (210:210), a total of 270 patients continued on second-line study treatment (64% of all), which consisted of capecitabine in 201 patients and of non-pegylated liposomal doxorubicin in 69 patients, evenly distributed between the treatment arms. Median PFS was 3.7 versus 5.0 months (HR 1.07; 95% CI: 0.82-1.38) and median OS 10.9 versus 12.4 months (HR 1.27; 95% CI: 0.98-1.66) for intermittent versus continuous second-line chemotherapy. Second-line PFS was positively influenced by prior hormonal therapy for metastatic disease and longer first-line PFS duration, while triple-negative tumor status had a negative influence. Patients with a shorter time to progression (TTP) in first-line (≤10 months) had a higher probability of starting second-line treatment if they received intermittent compared to continuous chemotherapy (OR 1.97; 95% CI: 1.02-3.80).Conclusion: We recommend continuous scheduling of both the first- and second-line chemotherapy for advanced breast cancer.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
Acta oncologica (Stockholm, Sweden) - 59(2020), 6 vom: 02. Juni, Seite 713-722 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Claessens, Anouk K M [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 17.12.2020 Date Revised 17.12.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/0284186X.2020.1731923 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM307298396 |
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| 100 | 1 | |a Claessens, Anouk K M |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Secondary analyses of the randomized phase III Stop&Go study |b efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 17.12.2020 | ||
| 500 | |a Date Revised 17.12.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Background: Previously, we showed that reintroduction of the same (first-line) chemotherapy at progression could only partially make up for the loss in efficacy as compared to continuously delivered first-line chemotherapy. Here, we report the probability of starting second-line study chemotherapy in the Stop&Go trial, and the progression-free survival (PFS) and overall survival (OS) of patients who received both the first- and second-line treatment in an intermittent versus continuous schedule.Methods: First-line chemotherapy comprised paclitaxel plus bevacizumab, second-line capecitabine or non-pegylated liposomal doxorubicin, given per treatment line as two times four cycles (intermittent) or as eight consecutive cycles (continuous).Results: Of the 420 patients who started first-line treatment within the Stop&Go trial (210:210), a total of 270 patients continued on second-line study treatment (64% of all), which consisted of capecitabine in 201 patients and of non-pegylated liposomal doxorubicin in 69 patients, evenly distributed between the treatment arms. Median PFS was 3.7 versus 5.0 months (HR 1.07; 95% CI: 0.82-1.38) and median OS 10.9 versus 12.4 months (HR 1.27; 95% CI: 0.98-1.66) for intermittent versus continuous second-line chemotherapy. Second-line PFS was positively influenced by prior hormonal therapy for metastatic disease and longer first-line PFS duration, while triple-negative tumor status had a negative influence. Patients with a shorter time to progression (TTP) in first-line (≤10 months) had a higher probability of starting second-line treatment if they received intermittent compared to continuous chemotherapy (OR 1.97; 95% CI: 1.02-3.80).Conclusion: We recommend continuous scheduling of both the first- and second-line chemotherapy for advanced breast cancer | ||
| 650 | 4 | |a Clinical Trial, Phase III | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 7 | |a liposomal doxorubicin |2 NLM | |
| 650 | 7 | |a Bevacizumab |2 NLM | |
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| 650 | 7 | |a Polyethylene Glycols |2 NLM | |
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| 650 | 7 | |a Doxorubicin |2 NLM | |
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| 650 | 7 | |a Receptor, ErbB-2 |2 NLM | |
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| 650 | 7 | |a Paclitaxel |2 NLM | |
| 650 | 7 | |a P88XT4IS4D |2 NLM | |
| 700 | 1 | |a Erdkamp, Frans L G |e verfasserin |4 aut | |
| 700 | 1 | |a Lopez-Yurda, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Bouma, Jeanette M |e verfasserin |4 aut | |
| 700 | 1 | |a Rademaker-Lakhai, Jeany M |e verfasserin |4 aut | |
| 700 | 1 | |a Honkoop, Aafke H |e verfasserin |4 aut | |
| 700 | 1 | |a de Graaf, Hiltje |e verfasserin |4 aut | |
| 700 | 1 | |a Tjan-Heijnen, Vivianne C G |e verfasserin |4 aut | |
| 700 | 1 | |a Bos, Monique E M M |e verfasserin |4 aut | |
| 700 | 0 | |a Dutch Breast Cancer Research Group (BOOG) |e verfasserin |4 aut | |
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