Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer

Background: Patients with first-line metastatic breast cancer (MBC) comprise patients with de novo metastases (dnMBC) or recurrent disease after primary breast cancer (rMBC). This analysis aimed to explore the prognostic value of dnMBC versus rMBC overall and particularly in subgroups according to a...

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Main Authors: Christina B. Walter, Andreas D. Hartkopf, Alexander Hein, Peter A. Fasching, Hans-Christian Kolberg, Peyman Hadji, Hans Tesch, Lothar Häberle, Johannes Ettl, Diana Lüftner, Markus Wallwiener, Volkmar Müller, Matthias W. Beckmann, Laura L. Michel, Erik Belleville, Hanna Huebner, Sabrina Uhrig, Chloë Goossens, Pauline Wimberger, Carsten Hielscher, Julia Meyer, Christoph Mundhenke, Christian Kurbacher, Rachel Wuerstlein, Michael Untch, Wolfgang Janni, Florin-Andrei Taran, Michael P. Lux, Diethelm Wallwiener, Sara Y. Brucker, Andreas Schneeweiss, Tanja N. Fehm, Carlo Fremd
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Language:English
Published: Elsevier 2025-04-01
Series:Breast
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Online Access:http://www.sciencedirect.com/science/article/pii/S0960977625000311
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author Christina B. Walter
Andreas D. Hartkopf
Alexander Hein
Peter A. Fasching
Hans-Christian Kolberg
Peyman Hadji
Hans Tesch
Lothar Häberle
Johannes Ettl
Diana Lüftner
Markus Wallwiener
Volkmar Müller
Matthias W. Beckmann
Laura L. Michel
Erik Belleville
Hanna Huebner
Sabrina Uhrig
Chloë Goossens
Pauline Wimberger
Carsten Hielscher
Julia Meyer
Christoph Mundhenke
Christian Kurbacher
Rachel Wuerstlein
Michael Untch
Wolfgang Janni
Florin-Andrei Taran
Michael P. Lux
Diethelm Wallwiener
Sara Y. Brucker
Andreas Schneeweiss
Tanja N. Fehm
Carlo Fremd
author_facet Christina B. Walter
Andreas D. Hartkopf
Alexander Hein
Peter A. Fasching
Hans-Christian Kolberg
Peyman Hadji
Hans Tesch
Lothar Häberle
Johannes Ettl
Diana Lüftner
Markus Wallwiener
Volkmar Müller
Matthias W. Beckmann
Laura L. Michel
Erik Belleville
Hanna Huebner
Sabrina Uhrig
Chloë Goossens
Pauline Wimberger
Carsten Hielscher
Julia Meyer
Christoph Mundhenke
Christian Kurbacher
Rachel Wuerstlein
Michael Untch
Wolfgang Janni
Florin-Andrei Taran
Michael P. Lux
Diethelm Wallwiener
Sara Y. Brucker
Andreas Schneeweiss
Tanja N. Fehm
Carlo Fremd
author_sort Christina B. Walter
collection DOAJ
description Background: Patients with first-line metastatic breast cancer (MBC) comprise patients with de novo metastases (dnMBC) or recurrent disease after primary breast cancer (rMBC). This analysis aimed to explore the prognostic value of dnMBC versus rMBC overall and particularly in subgroups according to age and metastasis site, in addition to other prognostic clinicopathological parameters in a first-line, hormone receptor (HR)-positive, HER2-negative (HRpos/HER2neg) population. Methods: Within the prospective PRAEGNANT MBC registry (NCT02338167), 508 HRpos/HER2neg patients, receiving first-line treatment for advanced disease, were identified. Clinicopathological parameters (age, body mass index, performance status, tumor grading, metastasis site and therapy) were assessed according to metastatic status (dnMBC, rMBC within 5 years of primary diagnosis (rMBC <5 years), rMBC after more than 5 years (rMBC ≥5 years)). Cox regression analyses were performed to investigate whether metastatic status influences progression-free survival (PFS) and overall survival (OS). Results: De novo metastatic disease was present in 180 patients (35.4 %), whereas 132 patients (26.0 %) had rMBC <5 years and 196 patients (38.6 %) had rMBC ≥5 years. Patients with dnMBC had the most favorable prognosis. Relative to dnMBC, hazard ratios for PFS were 1.75 (95%CI: 1.31–2.34) in rMBC<5 years and 1.25 (95%CI: 0.94–1.65) for rMBC ≥5 years. Subgroup-specific differences were not observed. Conclusion: HRpos/HER2neg first-line MBC patients have a more favorable prognosis if the disease was previously not treated. This difference was similar across all examined clinicopathological parameters. It may therefore be beneficial to incorporate MBC categories as a stratification factor in clinical trials.
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spelling doaj-art-576b4e4719f34d28a5186ddc96a3ecc22025-08-20T03:42:56ZengElsevierBreast1532-30802025-04-018010441210.1016/j.breast.2025.104412Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancerChristina B. Walter0Andreas D. Hartkopf1Alexander Hein2Peter A. Fasching3Hans-Christian Kolberg4Peyman Hadji5Hans Tesch6Lothar Häberle7Johannes Ettl8Diana Lüftner9Markus Wallwiener10Volkmar Müller11Matthias W. Beckmann12Laura L. Michel13Erik Belleville14Hanna Huebner15Sabrina Uhrig16Chloë Goossens17Pauline Wimberger18Carsten Hielscher19Julia Meyer20Christoph Mundhenke21Christian Kurbacher22Rachel Wuerstlein23Michael Untch24Wolfgang Janni25Florin-Andrei Taran26Michael P. Lux27Diethelm Wallwiener28Sara Y. Brucker29Andreas Schneeweiss30Tanja N. Fehm31Carlo Fremd32Department of Obstetrics and Gynecology, University of Tübingen, Tübingen, GermanyDepartment of Obstetrics and Gynecology, University of Tübingen, Tübingen, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Corresponding author. Department of Gynecology and Obstetrics, Erlangen University Hospital, Comprehensive Cancer Center Erlangen EMN, Friedrich Alexander University of Erlangen–Nuremberg, Universitätsstrasse 21–23, 91054, Erlangen, Germany.Department of Gynecology and Obstetrics, Marienhospital Bottrop, Bottrop, GermanyFrankfurt Center for Bone Health, Frankfurt am Main, GermanyOncology Practice, Bethanien Hospital, Frankfurt am Main, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Biostatistics Unit, Department of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen, GermanyDepartment of Obstetrics and Gynecology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Cancer Center Kempten/Allgäu (CCKA), Klinikum Kempten, Kempten, GermanyImmanuel Hospital Märkische Schweiz &amp; Immanuel Campus Rüdersdorf, Medical University of Brandenburg Theodor-Fontane, Rüdersdorf bei, Berlin, GermanyDepartment of Gynecology, Halle University Hospital, Halle, GermanyDepartment of Gynecology, Hamburg-Eppendorf University Medical Center, Hamburg, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Bavarian Center for Cancer Research (BZKF), Erlangen, GermanyNational Center for Tumor Diseases, Heidelberg University Hospital, German Cancer Research Center (DKFZ), Heidelberg, GermanyClinSol GmbH &amp; Co KG, Würzburg, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, GermanyDepartment of Gynecology and Obstetrics, Carl Gustav Carus Faculty of Medicine and University Hospital, TU Dresden, Dresden, Germany; National Center for Tumor Diseases (NCT), Dresden, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; Carl Gustav Carus Faculty of Medicine and University Hospital, Technical University of Dresden, Dresden, Germany; Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany; German Cancer Consortium (DKTK), Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germanyg.SUND Gynäkologie-Onkologisches Zentrum, Stralsund, GermanyDepartment of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Biostatistics Unit, Department of Gynecology and Obstetrics, Universitätsklinikum Erlangen, Erlangen, GermanyDepartment of Gynecology and Obstetrics, Klinik Hohe Warte, Bayreuth, GermanyDepartment of Gynecology I (Gynecologic Oncology), Gynecologic Center Bonn-Friedensplatz, Bonn, GermanyBreast Center and CCC Munich, Deptartment of Gynecology and Obstetrics, University Hospital LMU Munich, Munich, GermanyDepartment of Gynecology and Obstetrics, Helios Clinics Berlin-Buch, Berlin, GermanyDepartment of Gynecology and Obstetrics, Ulm University Hospital, Ulm, GermanyDepartment of Obstetrics and Gynecology, University Medical Center Freiburg, Freiburg, GermanyDepartment of Gynecology and Obstetrics, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Germany; St. Vincenz Kliniken Salzkotten + Paderborn, Paderborn, GermanyDepartment of Obstetrics and Gynecology, University of Tübingen, Tübingen, GermanyDepartment of Obstetrics and Gynecology, University of Tübingen, Tübingen, GermanyNational Center for Tumor Diseases, Heidelberg University Hospital, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of Gynecology and Obstetrics, Düsseldorf University Hospital, Düsseldorf, Germany; Center for Integrated Oncology Aachen Bonn Köln Düsseldorf, Düsseldorf, GermanyDepartment of Medical Oncology, University Hospital Heidelberg, Germany; Division of Gynecologic Oncology, National Center for Tumor Diseases Heidelberg, Germany; German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, GermanyBackground: Patients with first-line metastatic breast cancer (MBC) comprise patients with de novo metastases (dnMBC) or recurrent disease after primary breast cancer (rMBC). This analysis aimed to explore the prognostic value of dnMBC versus rMBC overall and particularly in subgroups according to age and metastasis site, in addition to other prognostic clinicopathological parameters in a first-line, hormone receptor (HR)-positive, HER2-negative (HRpos/HER2neg) population. Methods: Within the prospective PRAEGNANT MBC registry (NCT02338167), 508 HRpos/HER2neg patients, receiving first-line treatment for advanced disease, were identified. Clinicopathological parameters (age, body mass index, performance status, tumor grading, metastasis site and therapy) were assessed according to metastatic status (dnMBC, rMBC within 5 years of primary diagnosis (rMBC <5 years), rMBC after more than 5 years (rMBC ≥5 years)). Cox regression analyses were performed to investigate whether metastatic status influences progression-free survival (PFS) and overall survival (OS). Results: De novo metastatic disease was present in 180 patients (35.4 %), whereas 132 patients (26.0 %) had rMBC <5 years and 196 patients (38.6 %) had rMBC ≥5 years. Patients with dnMBC had the most favorable prognosis. Relative to dnMBC, hazard ratios for PFS were 1.75 (95%CI: 1.31–2.34) in rMBC<5 years and 1.25 (95%CI: 0.94–1.65) for rMBC ≥5 years. Subgroup-specific differences were not observed. Conclusion: HRpos/HER2neg first-line MBC patients have a more favorable prognosis if the disease was previously not treated. This difference was similar across all examined clinicopathological parameters. It may therefore be beneficial to incorporate MBC categories as a stratification factor in clinical trials.http://www.sciencedirect.com/science/article/pii/S0960977625000311Advanced breast cancerMetastasisde novo metastatic breast cancerFirst line therapyHormone receptor-positiveHER2-negative
spellingShingle Christina B. Walter
Andreas D. Hartkopf
Alexander Hein
Peter A. Fasching
Hans-Christian Kolberg
Peyman Hadji
Hans Tesch
Lothar Häberle
Johannes Ettl
Diana Lüftner
Markus Wallwiener
Volkmar Müller
Matthias W. Beckmann
Laura L. Michel
Erik Belleville
Hanna Huebner
Sabrina Uhrig
Chloë Goossens
Pauline Wimberger
Carsten Hielscher
Julia Meyer
Christoph Mundhenke
Christian Kurbacher
Rachel Wuerstlein
Michael Untch
Wolfgang Janni
Florin-Andrei Taran
Michael P. Lux
Diethelm Wallwiener
Sara Y. Brucker
Andreas Schneeweiss
Tanja N. Fehm
Carlo Fremd
Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
Breast
Advanced breast cancer
Metastasis
de novo metastatic breast cancer
First line therapy
Hormone receptor-positive
HER2-negative
title Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
title_full Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
title_fullStr Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
title_full_unstemmed Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
title_short Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer
title_sort characteristics and prognosis of patients with primary metastatic disease vs recurrent her2 negative hormone receptor positive advanced breast cancer
topic Advanced breast cancer
Metastasis
de novo metastatic breast cancer
First line therapy
Hormone receptor-positive
HER2-negative
url http://www.sciencedirect.com/science/article/pii/S0960977625000311
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