Preferences for the sequencing of first-line systemic treatments in metastatic hormone receptor-positive, HER2-negative breast cancer

• Published in: Frontiers in oncology Vol. 13; p. 1181375
• Main Authors: Al Mahmasani, Layal, Amhaz, Ghid, Abou Zeidane, Reine, Chamseddine, Nathalie, Hatab, Taha, Sabbagh, Saad, Charafeddine, Maya, Assi, Hazem I.
• Format: Journal Article
• Language: English
• Published: Frontiers Media S.A 18.10.2023
• Subjects: chemotherapy; hormone therapy; metastatic breast cancer; Oncology; preferences; sequence; targeted therapies
• ISSN: 2234-943X; 2234-943X
• DOI: 10.3389/fonc.2023.1181375

Introduction Metastatic breast cancer (MBC) is a diverse disease. Therapeutic options include hormonal therapy, chemotherapy, and targeted therapies. The optimal treatment sequence for patients with hormone receptor-positive (HR-positive), HER2-negative metastatic breast cancer remains unknown. Methods This was a retrospective and prospective study. The data was collected from the medical records of patients in a tertiary healthcare center in Lebanon between the years 2016 and 2019, and patients were followed up for a 3-year duration. The main aim was to identify oncologists’ preferences in the choice and sequence of treatment for newly diagnosed and/or recurrent cases of HR-positive, HER2-negative MBC. Results A total of 51 patients were included. 24 patients received chemotherapy, while 27 received endocrine therapy as first-line treatment after a diagnosis of MBC, with a median overall survival (OS) of 13 months and a median progression-free survival (PFS) of 12 months after first-line treatment with chemotherapy, compared to 27 months and 18 months with endocrine therapy. A higher percentage of patients have received chemotherapy in the first-line setting compared to the data reported in the literature, with the choice being multifactorial. Conclusion Factors to consider in MBC management include the choice of first-line treatment, the optimal sequence of treatment, and the combination of available treatment options.