A RETROSPECTIVE SURVEY OF SYSTEMIC ANTICANCER THERAPY IN WOMEN WITH METASTATIC BREAST CANCER (MBC) IN BELGIUM

Abstract

Introduction: Current treatment recommendations for MBC provide limited guidance for chemotherapy (CT), whereas physicians have many options to choose from, including potentially cardiotoxic agents. We undertook a retrospective survey to describe actual CT approaches to MBC in clinical practice in Belgium. Methods: Data were collected for metastatic patients diagnosed in 2003-2009 and treated with ‡1 CT regimen for MBC. Two academic centers and 18 general hospitals participated in the survey. Demographic, disease and treatment data of the last 25 consecutively treated pts per hospital were collected and analyzed. Prevalence of cardiovascular (CV) risk factors was determined as well. Results: 490 pts (mean age 59 yrs) were included. 44% had at least one CV risk factor at the time of MBC diagnosis, including hypertension (21%), hypercholesterolemia (17%), smoking (10%), and/or diabetes (7%) Percentages of pts receiving 1, 2, 3, 4, 5, and ‡6 lines of CT were 100, 79, 55, 30, 18, and 9%, respectively. Combination CT was given to 54% in line 1, 33% in line 2, and 35% in line 3. In line 1, taxane monotherapy (46%), FEC (40%), and taxane-trastuzumab combinations (19%) were the predominant regimens. Many different CT regimens were used throughout all lines, e.g. >20 regimens in line 1. Most pts had received a taxane (94%) or an anthracycline (60%), either as monotherapy or in combination CT, mostly in line 1 or 2. Elderly pts (‡70 yrs) received fewer consecutive lines of CT (32 vs. 61% received ‡3 lines), less combination CT (39 vs. 58% in line 1) and less toxic agents than younger pts. Date of the MBC diagnosis before or after Jan. 1, 2006 had no major effect on the type of CT given, although there was a tendency to a larger diversity of CT regimens in the later cohort. Conclusions: A wide diversity of monotherapy and combination CT regimens is used to treat MBC in Belgium throughout all lines of treatment. Nevertheless, taxanes and anthracyclines are the cornerstones of CT for MBC. Elderly pts are treated less intensively and with fewer regimens than younger pts. CV risk factors appeared to be highly prevalent in the survey population. This should be taken into account in the choice of CT for MBC and pt management.