Changing paradigms in the treatment of hormone-receptor positive advanced breast cancer

Figures & data

Table 1. Summary of randomized studies comparing endocrine therapy alone or with a biologic agent in metastatic, hormone-receptor positive breast cancer.

Author (Year)	Setting	ET alone	ET+ biologic	∆RR (∆CBR)^a Months	∆PFS^a Months	∆OS^a Months
Cristofanilli (2016) [7]	Failing prior endocrine therapy	Fulv.	Fulv+Palbo.	10% (27%)*	4.9*	-
Finn (2015) [6]	First-line metastatic	Letroz.	Letroz.+Palbo	9% (21%)*	10*	4.2
Piccart (2015) [8]	Failing prior NSAIs	Exem.	Exem.+ Everolimus	9.1%* (25%)*	4.1*	4.4
Bachelot (2012) [9]	Failing prior AIs	Tam.	Tam.+Everolimus	1% (19%)*	4.1*	0.45 (HR)*
Dickler (2015) [10]	First-line metastatic	Letroz.	Letroz.+ Bevacizumab	20%*^b (18%)*^b	4*	3
Martin (2015) [11]	First-line metastatic	Letroz.	Letroz.+Bevacizumab	18.9%* (9.4%)*	4.9*	N.S.

^aIncrease in response rate (RR), clinical benefit rate (CBR), progression-free survival (PFS), and overall survival (OS) of combined therapy vs. endocrine therapy alone.

^bCalculated in patients with measurable disease.

*Increase is statistically significant

Abbreviations: ET, endocrine therapy; NSAIs, non-steroidal aromatase inhibitors; AIs, aromatase inhibitors; HR, hazard ratio. Fulv, fulvestrant; Letroz., letrozole; Exem., exemestane; Tam., tamoxifen.

Cristofanilli M, Turner NC, Bondarenko I, et al. Fulvestrant plus palbociclib versus fulvestrant plus placebo for treatment of hormone-receptor-positive, HER2-negative metastatic breast cancer that progressed on previous endocrine therapy (PALOMA-3): final analysis of the multicentre, double-blind, phase 3 randomised controlled trial. Lancet Oncol. 2016 Mar 2. doi:10.1016/S1470-2045(15)00613-02016.

 Web of Science ®Google Scholar

Finn RS, Crown JP, Lang I, et al. The cyclin-dependent kinase 4/6 inhibitor palbociclib in combination with letrozole versus letrozole alone as first-line treatment of oestrogen receptor-positive, HER2-negative, advanced breast cancer (PALOMA-1/TRIO-18): a randomised phase 2 study. Lancet Oncol. 2015;16(1):25–35.

 PubMed Web of Science ®Google Scholar

Piccart M, Hortobagyi GN, Campone M, et al. Everolimus plus exemestane for hormone-receptor-positive, human epidermal growth factor receptor-2-negative advanced breast cancer: overall survival results from BOLERO-2. Ann Oncol. 2014;25(12):2357–2362.

 PubMed Web of Science ®Google Scholar

Bachelot T, Bourgier C, Cropet C, et al. Randomized phase II trial of everolimus in combination with tamoxifen in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative metastatic breast cancer with prior exposure to aromatase inhibitors: a GINECO study. J Clin Oncol. 2012;30(22):2718–2724.

 PubMed Web of Science ®Google Scholar

Dickler MN, Barry WT, Cirrincione CT, et al. Phase III trial evaluating the addition of bevacizumab to letrozole as first-line endocrine therapy for treatment of hormone-receptor positive avanced breast cancer. J Clin Oncol. 2015;33(15 Suppl). Abstr. 501.

 Web of Science ®Google Scholar

Martin M, Loibl S, von Minckwitz G, et al. Phase III trial evaluating the addition of bevacizumab to endocrine therapy as first-line treatment for advanced breast cancer: the letrozole/fulvestrant and avastin (LEA) study. J Clin Oncol. 2015;33(9):1045–1052.

 PubMed Web of Science ®Google Scholar