2008年至2017年荷兰新发her2阳性转移性乳腺癌患者的总生存期：一项基于人群的系统治疗患者队列研究

IF 7.6 1区医学 Q1 ONCOLOGY

European Journal of Cancer Pub Date : 2025-04-26 DOI:10.1016/j.ejca.2025.115475

Nan Ding , Karlijn E.P.E. Hermans , Thiemo J.A. van Nijnatten , Sanne M.E. Engelen , Jolien Tol , Loes Kooreman , Marie-Jeanne T.F.D. Vrancken-Peeters , Sabine Siesling , Adri C. Voogd , Vivianne C.G. Tjan-Heijnen , Sandra M.E. Geurts

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引用次数: 0

摘要

目的本研究旨在确定荷兰新生HER2阳性（HER2 +）转移性乳腺癌（MBC）患者的真实世界总生存期（OS）是否随着时间的推移而改善。方法从荷兰癌症登记处检索2008-2017年诊断为de Novo HER2 + MBC的患者数据。使用Kaplan-Meier方法估计每两年的OS，并使用log-rank检验趋势和多变量Cox比例风险分析进行比较，调整基线特征和局部治疗。每两年确定首次给予全身和局部治疗的使用。结果1458例患者中，99 %（1452/1458）为女性，53 %（775/1458）为诊断年龄在50-74岁之间。将2008-2009年诊断为de Novo HER2 + MBC的患者与2016-2017年进行比较，中位OS从30.9个月（95 %CI: 25.0 - 35.4）改善到57.5个月（95 %CI: 46.7 - 68.1）（趋势p值为0.001）（调整后的危险率比= 0.49,95 %CI: 0.40 - 0.59）。在同一时期，任何her2靶向治疗的使用从64% %（178/279）增加到84% %(287/340)，而基于pertuzumab的治疗的使用从0 %增加到67 %（227/340）。随着时间的推移，手术的使用保持稳定，而近年来原发性肿瘤和转移性肿瘤的放疗使用均有所增加，分别从2008 - 2009年的16% %（44/279）和15% %（42/279）增加到2016-2017年的22% %（76/340）和26% %（88/340）。结论：在2008年至2017年期间，荷兰诊断为de Novo HER2 + MBC的患者的os在10年内翻了一番。随着时间的推移，没有观察到转移性表现的变化，这表明改善的OS很可能是治疗改善的结果。

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Overall survival of patients with de Novo HER2-positive metastatic breast cancer in the Netherlands from 2008 to 2017: A population-based cohort study of systemically treated patients

Aim

This study aims to determine whether real-world overall survival (OS) of patients with de Novo HER2-positive (HER2 +) metastatic breast cancer (MBC) in the Netherlands improved over time.

Methods

Data of patients diagnosed with de Novo HER2 + MBC in 2008–2017 were retrieved from the Netherlands Cancer Registry. OS was estimated per two-year period using the Kaplan-Meier method and compared using the log-rank test for trend and the multivariable Cox proportional hazards analysis, adjusted for baseline characteristics and local therapy. First-given systemic and local therapy use was determined per two-year period.

Results

Among 1458 patients included, 99 % (1452/1458) were female and 53 % (775/1458) aged 50–74 years at diagnosis. Comparing patients diagnosed with de Novo HER2 + MBC in 2008–2009 versus 2016–2017, the median OS improved from 30·9 months (95 %CI:25·0–35·4) to 57·3 months (95 %CI:46·7–68·1) (p-value for trend<0·001) (adjusted hazard rate ratio =0·49, 95 %CI:0·40–0·59). The use of any HER2-targeted therapy increased from 64 % (178/279) to 84 % (287/340), while the use of pertuzumab-based therapy increased from 0 % to 67 % (227/340) over the same period. The use of surgery remained stable over time, while radiotherapy use for both the primary tumour and metastases increased in recent years, from 16 % (44/279) and 15 % (42/279) in 2008–2009–22 % (76/340) and 26 % (88/340) in 2016–2017, respectively.

Conclusion

OS has doubled over ten years, for patients diagnosed with de Novo HER2 + MBC in the Netherlands between 2008 and 2017. No change in metastatic presentation was observed over time, suggesting the improved OS is most likely explained by treatment improvements.

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来源期刊

European Journal of Cancer 医学-肿瘤学

CiteScore

11.50

自引率

4.80%

发文量

953

审稿时长

23 days

期刊介绍： The European Journal of Cancer (EJC) serves as a comprehensive platform integrating preclinical, digital, translational, and clinical research across the spectrum of cancer. From epidemiology, carcinogenesis, and biology to groundbreaking innovations in cancer treatment and patient care, the journal covers a wide array of topics. We publish original research, reviews, previews, editorial comments, and correspondence, fostering dialogue and advancement in the fight against cancer. Join us in our mission to drive progress and improve outcomes in cancer research and patient care.