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Response to second‐line chemotherapy in patients with metastatic breast carcinoma previously responsive to first‐line treatment
Author(s) -
Brun Bernard,
Benchalal Mohamed,
Lebas Christelle,
Piedbois Pascal,
Lin Ma,
Lebourgeois JeanPaul
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970601)79:11<2137::aid-cncr11>3.0.co;2-x
Subject(s) - chemotherapy , medicine , anthracycline , metastatic breast cancer , oncology , breast carcinoma , univariate analysis , surgery , breast cancer , cancer , multivariate analysis
BACKGROUND The aim of this retrospective study was to determine those prognostic factors associated with response to a second‐line chemotherapy in patients with metastatic breast carcinoma (MBC) that was previously responsive to a first‐line chemotherapy. METHODS The 70 MBC patients studied had previously responded to a first‐line chemotherapy, mainly anthracycline or anthracenedione‐containing regimens. During first‐line chemotherapy they had received treatment until the maximum response was obtained, at which time treatment was discontinued. Second‐line chemotherapy regimens were of several types (48.5% with anthracycline). A study of prognostic factors associated with response to second‐line chemotherapy was performed by univariate and multivariate analysis. RESULTS Second‐line chemotherapy achieved a 44% response rate, with a median response duration of 10 months. Survival was 13 months in the entire patient group, 22 months in responders, and 8 months in nonresponders. Univariate analysis identified seven factors related to patient response rate to second‐line treatment. A better response rate to second‐line chemotherapy was observed in patients with the following features: 1) chemotherapy free time (time between onset of metastatic disease and initiation of first‐line) < 12 months ( P = 0.03); 2) complete response to first‐line chemotherapy ( P = 0.013); 3) response duration to first‐line chemotherapy > 14 months ( P = 0.0001); 4) progression free interval (time between end of first‐line treatment and initiation of second‐line chemotherapy) > 11 months ( P = 0.0001); 5) performance status at second‐line treatment < 2 ( P = 0.04); 6) tumor index at second‐line chemotherapy < 4 ( P = 0.05); and 7) treatment with an anthracycline‐containing second‐line regimen ( P = 0.03). In multivariate analysis, only progression free interval was identified as being associated with response rate to second‐line chemotherapy ( P = 0.0001). CONCLUSIONS Retained chemosensitivity appeared to be an important characteristic in patients responding to second‐line chemotherapy. Cancer 1997; 79:2137‐46. © 1997 American Cancer Society.