For de novo metastatic breast cancer (DNMBC) patients, past evidence indicated that anthracyclines are beneficial in the first-two lines of palliative chemotherapy but with considerable toxic effects. However, with the provision of newer chemotherapies, comparative studies addressing the efficacy between anthracyclines and non-anthracyclines in the first-two lines of palliative chemotherapy for DNMBC were lacking.Methods
We collected clinicopathological characteristics of DNMBC patients who had received palliative chemotherapy in National Taiwan University Hospital between 2001 and 2006. Patients were classified as anthracycline or non-anthracycline group according to the first-two lines of chemotherapy. Kaplan–Meier method and log-rank test were used for the estimation and comparison of both overall survival (OS) and time to treatment failure of the first-two lines (TTF2). Cox proportional hazard model was used for OS and TTF2. Best composite response rate (BCRR) were compared with the logistic regression test.Results
A total of 121 patients, 58 (47.9%) in the anthracycline group and 63 (52.1%) in the non-anthracycline group, were analyzed. Between these two groups, the distributions of clinicopathological variables were generally similar. The median OS (33.1 versus 36.7 months, P = 0.91), median TTF2 (13.6 versus 17.2 months, P = 0.80), and BCRR (67.2 versus 66.7%; odds ratio 1.03, 95% CI 0.48–2.19, P = 0.95) were not significantly different. In multivariate analysis, early treatment with anthracyclines (anthracycline group) did not translated into improvements in OS (HR 1.02, 95% CI 0.64–1.63, P = 0.93) and TTF2 (HR 1.12, 95% CI 0.70–1.79, P = 0.65).Conclusion
Our study is the first study to demonstrate that anthracyclines may not be mandatory in the first-two lines of palliative chemotherapy for DNMBC. Future prospective studies are needed to evaluate the most proper early palliative chemotherapy for DNMBC patients in terms of both efficacy and toxicity.