Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer

Amélie Mallet; Amélie Lusque; Christelle Levy; Barbara Pistilli; Etienne Brain; David Pasquier; Marc Debled; Jean Christophe Thery; Anthony Gonçalves; Isabelle Desmoulins; Thibault De La Motte Rouge; Christelle Faure; Jean Marc Ferrero; Jean Christophe Eymard; Marie Ange Mouret-Reynier; Anne Patsouris; Paul Cottu; Florence Dalenc; Thierry Petit; Olivier Payen; Lionel Uwer; Séverine Guiu; Jean Sébastien Frenel

doi:10.1177/17588359211070362

Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer

Amélie Mallet, Amélie Lusque, Christelle Levy, Barbara Pistilli, Etienne Brain, David Pasquier, Marc Debled, Jean Christophe Thery, Anthony Gonçalves, Isabelle Desmoulins, Thibault De La Motte Rouge, Christelle Faure, Jean Marc Ferrero, Jean Christophe Eymard, Marie Ange Mouret-Reynier, Anne Patsouris, Paul Cottu, Florence Dalenc, Thierry Petit, Olivier PayenLionel Uwer, Séverine Guiu, Jean Sébastien Frenel

Résultats de recherche: Contribution à un journal › Article › Revue par des pairs

3 Citations (Scopus)

Résumé

Background: Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available. Methods: We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41–69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns. Results: Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20–40). Compared with women aged 41–69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR–/HER2– disease known as “triple negative breast cancer” (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2– patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0–51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2–, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015). Conclusion: De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

langue originale	Anglais
journal	Therapeutic Advances in Medical Oncology
Volume	14
Les DOIs	https://doi.org/10.1177/17588359211070362
état	Publié - 1 janv. 2022

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10.1177/17588359211070362

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Mallet, A., Lusque, A., Levy, C., Pistilli, B., Brain, E., Pasquier, D., Debled, M., Thery, J. C., Gonçalves, A., Desmoulins, I., De La Motte Rouge, T., Faure, C., Ferrero, J. M., Eymard, J. C., Mouret-Reynier, M. A., Patsouris, A., Cottu, P., Dalenc, F., Petit, T., ... Sébastien Frenel, J. (2022). Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer. Therapeutic Advances in Medical Oncology, 14. https://doi.org/10.1177/17588359211070362

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title = "Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer",

abstract = "Background: Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available. Methods: We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41–69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns. Results: Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20–40). Compared with women aged 41–69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR–/HER2– disease known as “triple negative breast cancer” (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2– patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0–51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2–, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015). Conclusion: De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.",

keywords = "de novo, metastatic breast cancer, prognosis, real-life, young women",

author = "Am{\'e}lie Mallet and Am{\'e}lie Lusque and Christelle Levy and Barbara Pistilli and Etienne Brain and David Pasquier and Marc Debled and Thery, {Jean Christophe} and Anthony Gon{\c c}alves and Isabelle Desmoulins and {De La Motte Rouge}, Thibault and Christelle Faure and Ferrero, {Jean Marc} and Eymard, {Jean Christophe} and Mouret-Reynier, {Marie Ange} and Anne Patsouris and Paul Cottu and Florence Dalenc and Thierry Petit and Olivier Payen and Lionel Uwer and S{\'e}verine Guiu and {S{\'e}bastien Frenel}, Jean",

note = "Publisher Copyright: {\textcopyright} The Author(s), 2022.",

year = "2022",

month = jan,

day = "1",

doi = "10.1177/17588359211070362",

language = "English",

volume = "14",

journal = "Therapeutic Advances in Medical Oncology",

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Mallet, A, Lusque, A, Levy, C, Pistilli, B, Brain, E, Pasquier, D, Debled, M, Thery, JC, Gonçalves, A, Desmoulins, I, De La Motte Rouge, T, Faure, C, Ferrero, JM, Eymard, JC, Mouret-Reynier, MA, Patsouris, A, Cottu, P, Dalenc, F, Petit, T, Payen, O, Uwer, L, Guiu, S & Sébastien Frenel, J 2022, 'Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer', Therapeutic Advances in Medical Oncology, VOL. 14. https://doi.org/10.1177/17588359211070362

TY - JOUR

T1 - Real-world evidence of the management and prognosis of young women (⩽40 years) with de novo metastatic breast cancer

AU - Mallet, Amélie

AU - Lusque, Amélie

AU - Levy, Christelle

AU - Pistilli, Barbara

AU - Brain, Etienne

AU - Pasquier, David

AU - Debled, Marc

AU - Thery, Jean Christophe

AU - Gonçalves, Anthony

AU - Desmoulins, Isabelle

AU - De La Motte Rouge, Thibault

AU - Faure, Christelle

AU - Ferrero, Jean Marc

AU - Eymard, Jean Christophe

AU - Mouret-Reynier, Marie Ange

AU - Patsouris, Anne

AU - Cottu, Paul

AU - Dalenc, Florence

AU - Petit, Thierry

AU - Payen, Olivier

AU - Uwer, Lionel

AU - Guiu, Séverine

AU - Sébastien Frenel, Jean

PY - 2022/1/1

Y1 - 2022/1/1

N2 - Background: Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available. Methods: We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41–69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns. Results: Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20–40). Compared with women aged 41–69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR–/HER2– disease known as “triple negative breast cancer” (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2– patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0–51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2–, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015). Conclusion: De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

AB - Background: Breast cancer (BC) in young women merits a specific approach given the associated fertility, genetic and psychosocial issues. De novo metastatic breast cancer (MBC) in young women is an even more serious condition, with limited data available. Methods: We evaluated management of women aged ⩽40 years with de novo MBC in a real-life national multicentre cohort of 22,463 patients treated between 2008 and 2016 (NCT0327531). Our primary objective was to compare overall survival (OS) in young women versus women aged 41–69 years. The secondary objectives were to compare first-line progression-free survival (PFS1) and to describe treatment patterns. Results: Of the 4524 women included, 598 (13%) were ⩽40 years. Median age at MBC diagnosis was 36 years (range = 20–40). Compared with women aged 41–69 years, young women had more grade III tumours (49% versus 35.7%, p < 0.0001), human epidermal growth factor receptor 2 amplified (HER2+) disease (34.6% versus 26.4%, p < 0.0001) and HR–/HER2– disease known as “triple negative breast cancer” (TNBC) (17.1% versus 12.7%, p < 0.0001). BRCA testing was performed for 260 young women, with a BRCA1/2 mutation in 44 (17% of those tested) In young HR+/HER2– patients, chemotherapy (CT) was given as the frontline treatment more frequently compared with older ones (89.6% versus 68.8%, respectively, p < 0.0001). After median follow-up of 49.7 months (95% confidence interval, CI = 48.0–51.7), the median OS of young women was 58.5 months, 20.7 months and not attained in HR+/HER2–, TNBC and HER2+ subgroups, respectively. After adjustment for histological subtype, tumour grade, and number and type of metastasis, young women had significantly better OS compared with older ones, except for the TNBC subgroup, for which the outcome was similar. PFS1 was statistically different only in the TNBC subgroup, with 7.8 months for young women and 6.3 months for older women (p = 0.0015). Conclusion: De novo MBC affects a significant proportion of young women. A subgroup of these patients achieves long OS and merits multidisciplinary care.

KW - de novo

KW - metastatic breast cancer

KW - prognosis

KW - real-life

KW - young women

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DO - 10.1177/17588359211070362

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