Isolated thoracic perfusion in lung metastases from breast cancer: a retrospective observational study

Abstract

The median overall survival of metastatic breast cancer (MBC) patients is still approximately 2 years. This is even lower in triple-negative breast cancer (TNBC) patients with concomitant lung metastases. These patients are often not suitable for surgery and not responsive to systemic chemotherapy. Isolated thoracic perfusion (ITP) followed by chemofiltration has been used for palliation in selected specialised centres. A retrospective observational study evaluating 162 MBC patients who underwent 407 ITP procedures was performed. The primary objective was the evaluation of the feasibility, safety, tolerability and efficacy of ITP in the complete cohort of 162 patients with LM from breast cancer. The secondary objective of the study was the evaluation of responses and median survivals in 43 TNBC patients with LM. In the 162 patients, ITP appeared safe and well tolerated with MST from LM diagnosis to death or last contact of 19.5 months. In the subgroup of patients treated with systemic chemotherapy followed by ITP at progression, the MST from LM diagnosis to death or last contact was 29 months. In the subgroup of TNBC patients treated with systemic chemotherapy followed by ITP at progression, the MST from LM diagnosis to death or last contact was 19 months (ITP overall response rate was 65.52%). ITP followed by chemofiltration could be adopted in the sequential palliation treatments of BC patients with LM in progression after systemic chemotherapy, especially with TNBC. The present data allow interesting considerations about tolerability and responses, but do not allow robust conclusions about survival.

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Acknowledgements

We would like to thank Giancarlo Palumbo (University of L’Aquila, Italy) for pharmacokinetic analyses, Kornelia Aigner (Department of Surgical Oncology, Medias Klinikum, Burghausen, Germany) and Gianni Lazzarin (University of L’Aquila, Italy) for data collection, Lucio Fumi (Wyfold Medical Consultancy, Oxford, UK) for English editing, and Società Italiana di Terapie Integrate Locoregionali in Oncologia (SITILO) for scientific support.

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Correspondence to Stefano Guadagni.

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The authors declare that there is no conflict of interest regarding the publication of this paper.

Research involving human participants and/or animals

This retrospective observational study had been conducted in accordance with the ethical standards of the Committee on Human Experimentation, after approval of the Ethics Committee in L’Aquila (n.10/CE/2018), and according to all rules for good clinical practice included in the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in this study.

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Guadagni, S., Aigner, K., Zoras, O. et al. Isolated thoracic perfusion in lung metastases from breast cancer: a retrospective observational study. Updates Surg 71, 165–177 (2019). https://doi.org/10.1007/s13304-018-00613-0

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Keywords

  • Breast cancer
  • Lung metastases
  • Triple-negative status
  • Isolated thoracic perfusion