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- Title
Secondary analyses of the randomized phase III Stop&Go study: efficacy of second-line intermittent versus continuous chemotherapy in HER2-negative advanced breast cancer.
- Authors
Claessens, Anouk K. M.; Erdkamp, Frans L. G.; Lopez-Yurda, Marta; Bouma, Jeanette M.; Rademaker-Lakhai, Jeany M.; Honkoop, Aafke H.; de Graaf, Hiltje; Tjan-Heijnen, Vivianne C. G.; Bos, Monique E. M. M.
- Abstract
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.
- Subjects
BREAST cancer prognosis; ANTIMETABOLITES; BREAST tumors; CANCER chemotherapy; CELL receptors; CONFIDENCE intervals; CONFERENCES &; conventions; DOXORUBICIN; DRUG administration; HORMONES; PACLITAXEL; PROBABILITY theory; SURVIVAL; THERAPEUTICS; TUMOR classification; TREATMENT effectiveness; BEVACIZUMAB; DISEASE progression; ODDS ratio
- Publication
Acta Oncologica, 2020, Vol 59, Issue 6, p713
- ISSN
0284-186X
- Publication type
Article
- DOI
10.1080/0284186X.2020.1731923