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Outcomes of systemic therapy in metastatic phyllodes tumor of the breast

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Abstract

Purpose

Metastatic phyllodes tumors of the breast (MPT) are rare breast neoplasms, limiting development of standardized treatment approaches. We sought to characterize the largest group of MPT thus far reported, evaluating systemic therapy outcomes.

Methods

Adult patients diagnosed with MPT between 1993 and 2015 and followed at MD Anderson Cancer Center were selected for retrospective chart review. Systemic therapy was sorted into: adriamycin/ifosfamide (AI), other anthracycline regimens, other ifosfamide regimens, gemcitabine-based regimens, and other. Given one patient may have received more than one regimen, we assumed that the effects of each regimen were independent from previous therapy. Median overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan–Meier method. Log-rank test was performed to evaluate the difference in OS between patient characteristics groups, and the differences in PFS between the five chemotherapy regimens.

Results

We identified 50 MPT patients, with 31 patients receiving 61 systemic regimens. Median OS was 10.7 months (95% CI: 8.67, 16.5). AI had a PFS of 9.10 months (95% CI: 5.03, 14.2), other ifosfamide regimens had a PFS of 5.10 months (95% CI: 0.67, 12.1), other anthracycline regimens had a PFS of 3.65 months (95% CI: 1.17, 7.90), gemcitabine-based regimens had a PFS of 2.80 months (95% CI: 1.83, 4.60), and other regimens had a PFS of 1.67 months (95% CI: 1.13, 7.77).

Conclusion

MPT patients are a unique population with limited characterization to date. Our study demonstrates activity of multiple sarcoma-directed chemotherapy regimens, with ifosfamide-containing regimens having the longest PFS.

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Data availability

The dataset(s) supporting the conclusions of this article are restricted to protect patient privacy. Deidentified data can be made available with approval from the MD Anderson IRB from corresponding author RR.

Code availability

Not applicable.

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Funding

No specific funding was obtained for this analysis.

Author information

Authors and Affiliations

  1. Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Amanda Parkes

  2. Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Wei-Lien Wang

  3. Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 450, Houston, TX, 77030, USA

    Shreyaskumar Patel, Anthony P. Conley, Neeta Somaiah, Dejka M. Araujo, Maria Zarzour, John Andrew Livingston, Joseph Ludwig, Vinod Ravi, Robert S. Benjamin & Ravin Ratan

  4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Cheuk Hong Leung & Heather Lin

  5. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA

    Christina L. Roland

  6. Department of Medicine, University of Wisconsin Carbone Cancer Center, 600 Highland Ave, Madison, WI, 53705, USA

    Amanda Parkes

Authors
  1. Amanda Parkes
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  2. Wei-Lien Wang
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  3. Shreyaskumar Patel
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  4. Cheuk Hong Leung
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  5. Heather Lin
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  6. Anthony P. Conley
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  7. Neeta Somaiah
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  8. Dejka M. Araujo
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  9. Maria Zarzour
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  10. John Andrew Livingston
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  11. Joseph Ludwig
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  12. Christina L. Roland
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  13. Vinod Ravi
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  14. Robert S. Benjamin
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  15. Ravin Ratan
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Contributions

AP: Conceptualization, chart review, writing–original draft, and writing–review and editing. WW: Pathology review of available slides and writing–review and editing. SP: Conceptualization and writing–review and editing. CHL: Formal analysis and writing–review and editing. HL: Formal analysis and writing–review and editing. AC: Writing–review and editing. NS: Writing–review and editing. DA: Writing–review and editing. MZ: Writing–review and editing. JAL: Writing–review and editing. JL: Writing–review and editing. CR: Writing–review and editing. VR: Writing–review and editing. RB: Conceptualization and writing–review and editing. RR: Conceptualization, supervision, and writing–review and editing. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Ravin Ratan.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

The study was conducted in accordance with all relevant guidelines and procedures and approved by the University of Texas MD Anderson Cancer Center Institutional Review Board. Informed consent requirement was waived given the retrospective design of the study.

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Parkes, A., Wang, WL., Patel, S. et al. Outcomes of systemic therapy in metastatic phyllodes tumor of the breast. Breast Cancer Res Treat 186, 871–882 (2021). https://doi.org/10.1007/s10549-021-06116-8

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  • DOI: https://doi.org/10.1007/s10549-021-06116-8

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