A Retrospective Series of Long-Term Survivors of Metastatic Breast Cancer in Complete Remission

Amoroso, Vito; Valcamonico, Francesca; Simoncini, Edda; Ardighieri, Laura; Grisanti, Salvatore; Vassalli, Lucia; Marpicati, P.; Lucini, Laura; Ferrari, Vittorio; Rangoni, G.; Marini, G

doi:10.1159/000084819

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…In our series, a significant correlation between the achievement of objectives response and subsequent PCB has been found, as previously showed in other retrospective analyses mainly conducted in metastatic breast cancer patients treated with high-dose chemotherapy and autologous hematopoietic stem cell support [28,29]. We also found a correlation between the number of previous treatments for advanced disease and probability of PCB.…”

Section: Discussionsupporting

confidence: 89%

Prolonged clinical benefit with metronomic chemotherapy in patients with metastatic breast cancer

Orlando¹,

Cardillo²,

Rocca³

et al. 2006

Anti-Cancer Drugs

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The clinical efficacy and antiangiogenic effect of low-dose, metronomic administration of cyclophosphamide (CTX) and methotrexate (MTX) (CM) have been demonstrated. The authors report results and long-term follow-up for patients with metastatic breast carcinoma who obtained prolonged clinical benefit with CM. Prospectively collected data from two successive clinical trials were evaluated. From July 1997 to October 2003, patients with metastatic breast carcinoma were treated with low-dose oral chemotherapy (MTX 2.5 mg, twice daily on day 1 and day 2 or 4, and CTX 50 mg daily). Patients who achieved prolonged clinical benefit for a duration of 12 months or more (complete remission, partial remission or stabilization of disease) were considered for the analysis. Median follow-up was 23 months. A total of 153 patients were enrolled and are evaluable: Eastern Cooperative Oncology Group performance status 0-1 in 90 patients, two or more sites of metastatic disease in 97 patients, zero regimen for metastatic breast carcinoma in 48 patients. Among 153 patients, five demonstrated complete remission and 25 partial remission. The proportion of patients who achieved prolonged clinical benefit was 15.7% (95% confidence interval 9.9-21.4%). Median time to progression for patients with prolonged clinical benefit was 21 months (range 12-37+ months). One patient maintained complete remission 42 months after therapy discontinuation. At the multivariate analysis endocrine responsiveness and the achievement of an objective response significantly correlated with the achievement of prolonged clinical benefit. Metronomic chemotherapy can induce prolonged clinical benefit in metastatic breast cancer, supporting its role as an additional therapeutic tool in the treatment of patients with metastatic breast carcinoma.

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Section: Discussionsupporting

confidence: 89%

Prolonged clinical benefit with metronomic chemotherapy in patients with metastatic breast cancer

Orlando¹,

Cardillo²,

Rocca³

et al. 2006

Anti-Cancer Drugs

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“…Although the majority of patients with MBC treated with trastuzumab-based regimens progress within one year [ 5 , 8 ], few patients experience prolonged remission [ 9 , 10 ]. Limited data have been published on long term remission under treatment with trastuzumab and are usually based on case reports or small patient numbers [ 11 – 13 ]. Aspects such as clinical predictive factors of long-term response to trastuzumab or the optimal duration of trastuzumab therapy in MBC patients achieving stable response remain to be reported.…”

Section: Introductionmentioning

confidence: 99%

Long-term tumor remission under trastuzumab treatment for HER2 positive metastatic breast cancer – results from the HER-OS patient registry

Witzel

Müller

Abenhardt³

et al. 2014

BMC Cancer

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BackgroundIn this study, we examined patients who had non-progressive disease for at least 2 years after diagnosis of inoperable locoregional recurrent or metastatic breast cancer under continuous trastuzumab treatment. Our primary goal was to assess the long-term outcome of patients with durable response to trastuzumab.Methods268 patients with HER2-positive inoperable locally recurrent or metastatic breast cancer and non-progressive disease for at least 2 years under trastuzumab treatment were documented retrospectively or prospectively in the HER-OS registry, an online documentation tool, between December 2006 and September 2010 by 71 German oncology centers. The study end point was time to tumor progression.ResultsOverall, 47.1% of patients (95% confidence interval (CI): 39.9–54.1%) remained in remission for more than 5 years, while the median time to progression was 4.5 years (95% CI: 4.0–6.6 years). Lower age (<50 years) and good performance status (ECOG 0) at time of trastuzumab treatment initiation as well as complete remission after initial trastuzumab treatment were associated with longer time to progression. Interruption of trastuzumab therapy correlated with shorter time to progression.ConclusionsHER2-positive patients, who initially respond to palliative treatment with trastuzumab, can achieve a long-term tumor remission of several years.

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“…The median survival was 42 months (range: 4–254 months) in 16.6% of patients who achieved CR after treatment with doxorubicin‐based combined chemotherapy and 3.1% of those remained disease free for more than 5 years. A retrospective series of long‐term survivors of MBC demonstrated that ER‐positive disease, ≤3 sites involved, good performance status, and previous exposure to anthracyclines were associated with increased CR rates (13,14). At a follow‐up of 11.7 years, 11 of 12 patients (91.7%) were still alive (14).…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective series of long‐term survivors of MBC demonstrated that ER‐positive disease, ≤3 sites involved, good performance status, and previous exposure to anthracyclines were associated with increased CR rates (13,14). At a follow‐up of 11.7 years, 11 of 12 patients (91.7%) were still alive (14). A more recent article reviewed 135 MBC patients treated between 1992 and 2008 and evaluated tumor/disease factors as possible survival predictors (13).…”

Section: Discussionmentioning

confidence: 99%

Surviving Metastatic Breast Cancer for 18 Years: A Case Report and Review of the Literature

et al. 2011

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We report a case of a 93-year-old woman who was diagnosed with estrogen receptor (ER)-positive, progesterone receptor-positive, T2N0M0 (stage I) breast cancer (BC) at the age of 45. Twenty-two years later, she was diagnosed with metastatic lesions to the lungs consistent with the breast primary. Her disease was stable on tamoxifen, anastrozole, and exemestane for 14 years. Subsequently, she was found to have metastatic lesions to thoracic spine as well as progressively increasing bilateral pleural effusions. At that time, she was deemed not to be a good candidate for chemotherapy and therapy was changed to fulvestrant. Two years later (38 years after initial diagnosis of BC), she was diagnosed with new metastatic liver lesions; although her pulmonary and bone metastases remained stable. Therefore, she was started on palliative chemotherapy with single-agent capecitabine. The treatment was discontinued after the second cycle upon the patient's request owing to grade 2 hand and foot syndrome. She expired 2 years later after fighting BC for four decades. She survived for 18 years after the diagnosis of metastatic breast cancer (MBC) while maintaining a good quality of life. To the authors' knowledge, this is the first reported case in the literature with the longest overall survival in a patient with MBC. We provide a detailed clinical analysis in conjunction with a brief literature review.

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A Retrospective Series of Long-Term Survivors of Metastatic Breast Cancer in Complete Remission

Cited by 8 publications

References 19 publications

Prolonged clinical benefit with metronomic chemotherapy in patients with metastatic breast cancer

Prolonged clinical benefit with metronomic chemotherapy in patients with metastatic breast cancer

Long-term tumor remission under trastuzumab treatment for HER2 positive metastatic breast cancer – results from the HER-OS patient registry

Surviving Metastatic Breast Cancer for 18 Years: A Case Report and Review of the Literature

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