Background: Elucidating the clinical features of metastatic breast cancer (MBC) patients with an exceptionally favorable prognosis may offer insights to improve the survival of more typical patients. Methods: We collected comprehensive real-world data on clinicopathologic characteristics, treatments, and outcomes of 110 consecutive MBC patients who survived for over ten years from the clinical data warehouse of Samsung Medical Center. Results: The cohort included 54 hormone receptor (HR)-positive/HER2-negative (HR+/HER2−), 21 HR+/HER2+, 16 HR−/HER2+, and 14 triple-negative breast cancer (TNBC) patients. The median age at MBC diagnosis was 48.5 years. Approximately 70% of patients initially had a single-organ metastasis. The most common site of metastasis was the lung (46.4%), followed by distant lymph nodes (37.3%). During a median follow-up of 14.6 years, the median duration of systemic therapy was 11, 8.4, 7.3, and 0.8 years in the HR+/HER2−, HR+/HER2+, HR−/HER2+, and TNBC subgroups, respectively. Seven HER2+ and ten TNBC patients received systemic treatment for less than two years and remained treatment-free for most of the follow-up period, suggesting a potential chance of cure. The TNBC subtype (p< 0.001) and local treatment with curative intent within 1 year of MBC diagnosis (p= 0.002) were significantly associated with long-term treatment-free survival. The survival of HER2+ MBC and TNBC patients, but not that of HR+/HER2− patients, plateaued approximately 13 years after MBC diagnosis. Conclusions: A small subset of patients with HER2+ MBC and metastatic TNBC may be curable with multimodality therapy. Prospective studies integrating clinical and genomic data may identify unique clinicogenomic features of MBC patients who can achieve durable disease control without prolonged chemotherapy.
背景：阐明具有极佳预后的转移性乳腺癌（MBC）患者的临床特征，可能为改善更多典型患者的生存提供启示。方法：我们从三星医疗中心的临床数据仓库中，连续收集了110例生存超过十年的MBC患者的完整真实世界数据，包括其临床病理特征、治疗方案和结局。结果：该队列包括54例激素受体（HR）阳性/HER2阴性（HR+/HER2−）、21例HR+/HER2+、16例HR−/HER2+以及14例三阴性乳腺癌（TNBC）患者。MBC诊断时的中位年龄为48.5岁。约70%的患者最初为单器官转移。最常见的转移部位是肺（46.4%），其次是远处淋巴结（37.3%）。在中位随访14.6年期间，HR+/HER2−、HR+/HER2+、HR−/HER2+和TNBC亚组患者接受全身治疗的中位持续时间分别为11年、8.4年、7.3年和0.8年。有7例HER2+患者和10例TNBC患者接受全身治疗的时间少于两年，并且在大部分随访期间未再接受治疗，提示其存在潜在的治愈可能。TNBC亚型（p<0.001）以及在MBC诊断后1年内接受以治愈为目的的局部治疗（p=0.002）与长期无治疗生存显著相关。HER2+ MBC和TNBC患者的生存曲线在MBC诊断后约13年进入平台期，而HR+/HER2−患者则未出现此现象。结论：一小部分HER2+ MBC和转移性TNBC患者可能通过多模式治疗获得治愈。整合临床与基因组数据的前瞻性研究，或可识别出那些无需长期化疗即可实现持久疾病控制的MBC患者所特有的临床-基因组特征。
Comprehensive Clinical Characterization of Decade-Long Survivors of Metastatic Breast Cancer
肿瘤(癌症)患者之家