NOTTINGHAM, UKStable disease appears to be a clinically relevant category
for judging the effectiveness of hormonal therapy in metastatic breast
cancer, John Robertson, MD, said in his poster presentation of a study
from the Department of Surgery, City Hospital, Nottingham.
In this study of 255 breast cancer patients who received both first-
and second-line hormonal therapy, patients with stable (or static) disease
for six months had the same survival as patients who had an objective response
(complete or partial remission).
"Therefore," Dr. Robertson said, "we should link these
static disease patients with the responders and call them nonprogressors,
with all others grouped into a progressive disease category."
This finding is important, he said, because with both first- and second-line
hormonal therapy, a large percentage of patients have stable disease. "Over
40% of patients would be denied a benefit if physicians stopped treatment
in patients with static disease," he said.
He noted that a number of clinicians already recognize this and keep
patients on treatment while the disease is stable, "but they've never
really been sure of the value of it. This study reassures the clinician
that the patient should remain on treatment."
It also may be reassuring to patients to know that their cancer is being
controlled even though it has not gotten smaller.
Finally, he said, recognizing the importance of stable disease simplifies
treatment decision making, because progressive disease is easier to identify
than responses. "Patients can be treated purely on the premise that
you change treatment when progression is diagnosed."