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Maintenance chemotherapy after 6 cycles of platinum-doublet regimen in anthracycline-and taxane-pretreated metastatic breast cancer

Korean Journal of Internal Medicine 2021년 36권 1호 p.182 ~ 193
안순현, 양지현, Oh Soo-Eun, 박세준, 이지은,
소속 상세정보
안순현 ( Ahn Soon-Hyun ) - Catholic University College of Medicine Department of Internal Medicine
양지현 ( Yang Ji-Hyun ) - Catholic University College of Medicine Uijeongbu St. Mary’s Hospital Department of Internal Medicine
 ( Oh Soo-Eun ) - Catholic University College of Medicine Department of Hospital Pathology
박세준 ( Park Se-Jun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
이지은 ( Lee Ji-Eun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine

Abstract


Background/Aims: Sequential monotherapy is recommended for anthracycline-and taxane-resistant metastatic breast cancer (MBC), but combination chemotherapy is considered in patients with visceral crisis. Cisplatin-doublet chemotherapy is a combination regimen for MBC, but prolonged treatment is challenging because of toxicity. We analyzed the role of single-agent maintenance chemotherapy after cisplatin-doublet chemotherapy for MBC.

Methods: From January 2011 to December 2017, 96 anthracycline- and taxane-resistant MBC patients were retrospectively reviewed, and 49 patients with a sustained clinical benefit during the initial 6 cycles of cisplatin-doublet chemotherapy were enrolled for study. Patients were treated with gemcitabine-cisplatin (gemcitabine, 1,250 mg/m2, intravenously [IV], days 1 to 8; cisplatin 60 mg/m2, IV, day 1) or capecitabine-cisplatin (capecitabine 2,500 mg/m2, orally, days 1 to 14; cisplatin 60 mg/m2, IV, day 1) during the induction period. After 6 cycles, 16 patients were switched to single-maintenance treatment (gemcitabine or capecitabine) and the doublet regimen was continued in 24 patients. Survival outcomes (progression-free survival [PFS] and overall survival [OS]) were analyzed.

Results: Among the 49 patients who showed a clinical benefit during cisplatin-doublet therapy, 24 were maintained on the doublet regimen, 16 were switched to single-maintenance treatment, and chemotherapy was suspended until disease progression in nine patients. The single-maintenance chemotherapy group showed superior survival than the chemotherapy holiday and doublet regimen groups (median PFS 15.43 months vs. 8.37 and 10.67 months, respectively, p = 0.008; median OS 43.67 months vs. 22.17 and 22.33 months, respectively, p = 0.014).

Conclusions: Patients showing a clinical benefit during 6 cisplatin-doublet chemotherapy cycles may have a sustained survival benefit from single-maintenance chemotherapy.

키워드

Breast neoplasms; Cisplatin; Maintenance chemotherapy

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