Response to chemotherapy is a major parameter-influencing long-term survival of metastatic breast cancer patients

Background:In cancer patients, correlation between response tochemotherapy and gain in survival remains debated. We addressed this questionin a multivariate analysis evaluating response to chemotherapy as a factorinfluencing survival of patients with metastatic breast cancer.Patients and methods:From 1977 to 1992, 1430 patients includedin eight consecutive prospective trials of anthracycline-based first-linechemotherapy in metastatic breast cancer, were available for assessment.Median follow-up was 155 months.Results:Median survival from the date of randomisation was 24months. Objective response rate was 63.6%. A complete response (CR) wasachieved in 17% (249 patients). In a stepwise forward progressionanalysis objective response was the first independent prognostic factor forsurvival. Median survival time was 43 months for complete responders (CR), 29months for partial responders (PR), 18 months for stable disease (SD), 5months for progressive disease (PD). The probability of survival at 5 and 10years was 35% and 15% for CR's and decreased to 18%and 6% for PR's. The timing of best response (at 4 or 8 months)was not related to outcome.Conclusions:Response to an anthracycline-based chemotherapy isa major independent prognostic factor in metastatic breast cancer. The use ofthis factor to investigate new drugs seems to be pertinent. The good prognosisof complete responders justifies further evaluation of new treatmentstrategies for this patient population.