Patient-Reported Outcomes After Switch to Endocrine Therapy in Metastatic Breast Cancer
Posted: Wednesday, December 16, 2020
Patients with estrogen receptor–positive HER2-negative metastatic breast cancer who switched to maintenance endocrine therapy following induction chemotherapy reported significantly improved physical well-being and fatigue compared with patients who continued chemotherapy, according to the patient-reported outcomes of a study presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020 (Abstract 328P). Switching to maintenance endocrine therapy also appeared to prevent serious chemotherapy-induced peripheral neuropathy, reported Shigehira Saji, MD, PhD, of Fukushima Medical University Hospital, Japan, and colleagues.
In this open-label phase II clinical trial, 125 patients with estrogen receptor–positive, HER2-negative metastatic breast cancer received induction chemotherapy with 4 to 6 cycles of weekly paclitaxel and bevacizumab. Following induction, patients were randomly assigned to receive continuation of the same regimen (n = 63) or switch to maintenance endocrine therapy plus bevacizumab until disease progression and retreatment with chemotherapy upon disease progression (n = 62). As previously reported, the time to treatment failure was significantly longer in the maintenance arm (16.82 months) compared with the chemotherapy arm (8.87 months).
Patient-reported Functional Assessment of Cancer Therapy–Breast Cancer (FACT-B) trial outcome index scores—a quality-of-life assessment that includes physical and functional well-being and breast cancer–specific symptoms—were significantly higher with maintenance endocrine therapy compared with chemotherapy (P = .004). The mean changes of the FACT-B physical well-being subscore were also better with maintenance endocrine therapy than with chemotherapy at 2 months (P = .015) and 4 months (P = .028). Patients reported lower rates of severe motor chemotherapy-induced peripheral neuropathy at 1 year in the endocrine maintenance group than the chemotherapy group (5.1% vs. 26.1%, P = .017). Fatigue was significantly less frequent in the maintenance endocrine arm as well.
Disclosure: For full disclosure of the study authors, visit oncologypro.esmo.org.