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Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland

BACKGROUND: Comparing breast cancer survival trends globally, Finland is among the top three countries in Europe. However, outcome data on breast cancer subgroups in the Finnish population are limited. This retrospective, registry‐based study aimed to assess patient characteristics and clinical outc...

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Autores principales: Teerenhovi, Heli, Tuominen, Samuli, Nurmi‐Rantala, Susanna, Hemmilä, Päivikki, Ellonen, Antti
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342560/
https://www.ncbi.nlm.nih.gov/pubmed/33955109
http://dx.doi.org/10.1002/onco.13813
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author Teerenhovi, Heli
Tuominen, Samuli
Nurmi‐Rantala, Susanna
Hemmilä, Päivikki
Ellonen, Antti
author_facet Teerenhovi, Heli
Tuominen, Samuli
Nurmi‐Rantala, Susanna
Hemmilä, Päivikki
Ellonen, Antti
author_sort Teerenhovi, Heli
collection PubMed
description BACKGROUND: Comparing breast cancer survival trends globally, Finland is among the top three countries in Europe. However, outcome data on breast cancer subgroups in the Finnish population are limited. This retrospective, registry‐based study aimed to assess patient characteristics and clinical outcomes of different breast cancer subgroups in early (EBC) and metastatic breast cancer (MBC) in a real‐life clinical setting. MATERIALS AND METHODS: The study consisted of 6,977 adult, female patients with breast cancer diagnosed in Southwest Finland during 2005–2018. Patients were divided into four mutually exclusive groups: human epidermal growth factor receptor 2 positive (HER2+), triple negative, HER2−/hormone receptor positive (HR+), and HER2 and/or HR status unknown, and further into patients with EBC and MBC. Overall survival (OS) was assessed as a clinical outcome, as well as the following real‐world (rw) clinical outcomes: disease‐free survival (rwDFS), progression‐free survival (rwPFS), and distant recurrence‐free interval (rwDRFI). RESULTS: Within EBC, 5‐year survival was the highest (88%) in HER2−/HR+, followed by 85% in HER2+, and 75% in triple negative. The rwDFS varied significantly in EBC (5‐year rwDFS HER2 ‐/HR+, HER2+, triple negative: 87%, 80%, 71% respectively). In MBC, median survival was 2 years for both HER2−/HR+ and HER2+ and markedly shorter for triple negative (0.8 years). Independent predictors of mortality were age (hazard ratio [HR], 1.1), other subgroups than HER2−/HR+ (HR, 1.2–1.9), metastatic disease (HR, 9.8), and other malignancies (HR, 2.7). CONCLUSION: This registry‐based study demonstrates significant differences in breast cancer outcomes on the subgroup level, as well as poorer outcomes compared with clinical trials, giving complementary insight on clinical characteristics in an unselected patient population. IMPLICATIONS FOR PRACTICE: This retrospective, registry‐based study assessed the clinical outcomes of different breast cancer subgroups in 6,977 adult, female patients with breast cancer diagnosed in Southwest Finland during 2005–2018. Results demonstrated significant variation in the survival between subgroups in both early breast cancer and metastatic breast cancer, as well as differences between unselected patients representing the standard of care and randomized clinical trials. Although, according to the global comparison of survival trends, the net survival of patients with breast cancer in Finland is generally high, there is great variation between subgroups. These real‐life breast cancer data provide tools to further evaluate medical need in different breast cancer subgroups.
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spelling pubmed-83425602021-08-11 Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland Teerenhovi, Heli Tuominen, Samuli Nurmi‐Rantala, Susanna Hemmilä, Päivikki Ellonen, Antti Oncologist European Perspectives BACKGROUND: Comparing breast cancer survival trends globally, Finland is among the top three countries in Europe. However, outcome data on breast cancer subgroups in the Finnish population are limited. This retrospective, registry‐based study aimed to assess patient characteristics and clinical outcomes of different breast cancer subgroups in early (EBC) and metastatic breast cancer (MBC) in a real‐life clinical setting. MATERIALS AND METHODS: The study consisted of 6,977 adult, female patients with breast cancer diagnosed in Southwest Finland during 2005–2018. Patients were divided into four mutually exclusive groups: human epidermal growth factor receptor 2 positive (HER2+), triple negative, HER2−/hormone receptor positive (HR+), and HER2 and/or HR status unknown, and further into patients with EBC and MBC. Overall survival (OS) was assessed as a clinical outcome, as well as the following real‐world (rw) clinical outcomes: disease‐free survival (rwDFS), progression‐free survival (rwPFS), and distant recurrence‐free interval (rwDRFI). RESULTS: Within EBC, 5‐year survival was the highest (88%) in HER2−/HR+, followed by 85% in HER2+, and 75% in triple negative. The rwDFS varied significantly in EBC (5‐year rwDFS HER2 ‐/HR+, HER2+, triple negative: 87%, 80%, 71% respectively). In MBC, median survival was 2 years for both HER2−/HR+ and HER2+ and markedly shorter for triple negative (0.8 years). Independent predictors of mortality were age (hazard ratio [HR], 1.1), other subgroups than HER2−/HR+ (HR, 1.2–1.9), metastatic disease (HR, 9.8), and other malignancies (HR, 2.7). CONCLUSION: This registry‐based study demonstrates significant differences in breast cancer outcomes on the subgroup level, as well as poorer outcomes compared with clinical trials, giving complementary insight on clinical characteristics in an unselected patient population. IMPLICATIONS FOR PRACTICE: This retrospective, registry‐based study assessed the clinical outcomes of different breast cancer subgroups in 6,977 adult, female patients with breast cancer diagnosed in Southwest Finland during 2005–2018. Results demonstrated significant variation in the survival between subgroups in both early breast cancer and metastatic breast cancer, as well as differences between unselected patients representing the standard of care and randomized clinical trials. Although, according to the global comparison of survival trends, the net survival of patients with breast cancer in Finland is generally high, there is great variation between subgroups. These real‐life breast cancer data provide tools to further evaluate medical need in different breast cancer subgroups. John Wiley & Sons, Inc. 2021-06-01 2021-08 /pmc/articles/PMC8342560/ /pubmed/33955109 http://dx.doi.org/10.1002/onco.13813 Text en © 2021 The Authors. The Oncologist published by Wiley Periodicals LLC on behalf of AlphaMed Press. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle European Perspectives
Teerenhovi, Heli
Tuominen, Samuli
Nurmi‐Rantala, Susanna
Hemmilä, Päivikki
Ellonen, Antti
Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title_full Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title_fullStr Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title_full_unstemmed Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title_short Real‐World Clinical Outcomes in Biological Subgroups of Breast Cancer in the Hospital District of Southwest Finland
title_sort real‐world clinical outcomes in biological subgroups of breast cancer in the hospital district of southwest finland
topic European Perspectives
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342560/
https://www.ncbi.nlm.nih.gov/pubmed/33955109
http://dx.doi.org/10.1002/onco.13813
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