Prognostic Factors for Treatment Outcomes of First Line Chemotherapy in Metastatic Breast Cancer

Background: A large number of old and new chemotherapeutic agents are now used in the treatment of metastatic breast cancer (MBC) patients .The choice of chemotherapy regimen depends on several factors concerning not only the tumor's characteristics, but also the patient preference, so the clinician must identify the prognostic factors that may help in tailoring treatment to each patient. The aim of the study was to evaluate the prognostic factors for response, time to tumor progression (TTP) and overall survival (OS) after the first line chemotherapy for MBC.Patients and Methods: The study included 30 eligible women who had measurable metastatic disease and prior anthracycline based treatment in the adjuvant setting. All patients received cisplatin 75 mg/m2 on day 1 and gemcitabine 1000 mg/m2 on days 1&8 of 21-day-cycles to a maximum 8 cycles. Prognostic factors studied were performance status (P.S), age, grade, menopausal status, hormonal receptor status, disease free interval (DFI) and number of metastatic sites.RESULTS: Partial response was found in 43.3% (13) of the patients. Median TTP was 10 months. Median OS was 12 months. Prognostic factors significant for response were performance status (P=0.04), number of metastatic sites (P=0.02) and disease free interval (P=0.002). Prognostic factor for TTP was performance status (P=0.03), for overall survival performance status (0.009) and hormonal receptor (P=0.008).Conclusion: Prior to the initiation of first line chemotherapy for metastatic breast cancer, it is necessary to evaluate the performance status, number of metastatic sites and disease free interval to tailor treatment to achieve maximum benefit for the patients.