A team of researchers from Italy conducted the study and published their findings in Breast Cancer Research and Treatment.
The goal of their study was to “assess the incidence and determinants” of a reduction in early first-line SACT “after metastatic recurrence” in TNBC that has been previously treated with neoadjuvant chemo-immunotherapy.
The “retrospective multicenter analysis” consisted of 209 “consecutive” patients who were diagnosed with early-stage TNBC and who underwent neoadjuvant chemo-immunotherapy. The median follow-up was 24 months, after which 54 patients “developed metastatic recurrence.”
For the purposes of the study, early first-line SACT attrition “was defined as failure to initiate [SACT] within 90 days of documented recurrence.” Furthermore, investigators highlighted that univariate and multivariable logistic regression were used to analyze associations.
Of the 54 patients who developed metastatic recurrence, 32.7% (n=17) experienced SACT attrition. The results revealed that “patients who did not initiate treatment had a significantly shorter disease-free interval compared to those who received first-line therapy (median 7.4 vs 14.3 months; P=0.011).”
Investigators also reported that among patients who experienced SACT attrition, “PD-L1 positivity was more frequent” (64.7%) and “central nervous system metastases were more commonly observed” (41.2%).
Overall survival (OS) findings demonstrated that median OS “from metastatic recurrence” was 3.4 months and 12.4 months in the attrition and non-attrition cohorts, respectively. Results from the multivariable analysis showed that “shorter disease-free interval (OR 0.87 per month; 95% CI 0.78-0.97), PD-L1 positivity (OR 8.73; 95% CI 1.81-42.04), and presence of central nervous system metastases (OR 7.09; 95% CI 1.41-35.57) were independently associated with early first-line therapeutic attrition.”
Investigators summarized the key takeaway of the real-world multicenter cohort study, which showed that “nearly one-third of patients with TNBC experiencing metastatic recurrence after neoadjuvant chemo-immunotherapy did not initiate first-line systemic therapy within a clinically relevant timeframe.”