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

Walter CB, Hartkopf AD, Hein A, Fasching P, Kolberg HC, Hadji P, Tesch H, Häberle L, Ettl J, Lüftner D, Wallwiener M, Müller V, Beckmann M, Michel LL, Belleville E, Hübner H, Uhrig S, Goossens C, Wimberger P, Hielscher C, Meyer J, Mundhenke C, Kurbacher C, Wuerstlein R, Untch M, Janni W, Taran FA, Lux MP, Wallwiener D, Brucker SY, Schneeweiss A, Fehm TN, Fremd C (2025)

Publication Type: Journal article

Publication year: 2025

Journal

Book Volume: 80

Article Number: 104412

DOI: 10.1016/j.breast.2025.104412

Abstract

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.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Tübingen Germany (DE) Marienhospital Bottrop Germany (DE) Frankfurter Hormon und Osteoporosezentrum Germany (DE) Agaplesion Markus Krankenhaus Germany (DE) Klinikum rechts der Isar Germany (DE) Medizinische Hochschule Brandenburg "Theodor Fontane" / Brandenburg Medical School "Theodor Fontane" Germany (DE) Martin-Luther-Universität Halle-Wittenberg (MLU) Germany (DE) Universitätsklinikum Heidelberg Germany (DE) ClinSol GmbH & Co.KG Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Gynäkologie Kompetenzzentrum Stralsund: gSUND Germany (DE) Klinikum Bayreuth Germany (DE) Universitätsklinikum Freiburg Germany (DE) Heinrich-Heine-Universität Düsseldorf Germany (DE) St. Josefs-Krankenhaus Salzkotten Germany (DE) Klinikum der Universität München Germany (DE) HELIOS Kliniken Germany (DE) Universitätsklinikum Ulm Germany (DE)

How to cite

APA:

Walter, C.B., Hartkopf, A.D., Hein, A., Fasching, P., Kolberg, H.C., Hadji, P.,... Fremd, C. (2025). Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer. BREAST , 80. https://doi.org/10.1016/j.breast.2025.104412

MLA:

Walter, Christina B., et al. "Characteristics and prognosis of patients with primary metastatic disease vs. recurrent HER2-negative, hormone receptor-positive advanced breast cancer." BREAST 80 (2025).

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