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

Layal Al Mahmasani; Ghid Amhaz; Reine Abou Zeidane; Nathalie Chamseddine; Taha Hatab; Saad Sabbagh; Maya Charafeddine; Hazem I Assi

doi:10.3389/fonc.2023.1181375

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

Front Oncol. 2023 Oct 18:13:1181375. doi: 10.3389/fonc.2023.1181375. eCollection 2023.

Authors

Layal Al Mahmasani¹, Ghid Amhaz¹, Reine Abou Zeidane¹, Nathalie Chamseddine², Taha Hatab³, Saad Sabbagh³, Maya Charafeddine¹, Hazem I Assi¹

Affiliations

¹ Naef K. Basile Cancer Institute, Division of Hematology and Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
² Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon.
³ Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Abstract

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.

Keywords: chemotherapy; hormone therapy; metastatic breast cancer; preferences; sequence; targeted therapies.