Stable Disease May Be a Valid Criterion for Continuing Hormonal Treatment in Metastatic Breast Cancer Patients

NOTTINGHAM, UK—Stable disease appears to be a clinically relevant categoryfor judging the effectiveness of hormonal therapy in metastatic breastcancer, John Robertson, MD, said in his poster presentation of a studyfrom 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) diseasefor six months had the same survival as patients who had an objective response(complete or partial remission).

"Therefore," Dr. Robertson said, "we should link thesestatic 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-linehormonal therapy, a large percentage of patients have stable disease. "Over40% of patients would be denied a benefit if physicians stopped treatmentin patients with static disease," he said.

He noted that a number of clinicians already recognize this and keeppatients on treatment while the disease is stable, "but they've neverreally been sure of the value of it. This study reassures the clinicianthat the patient should remain on treatment."

It also may be reassuring to patients to know that their cancer is beingcontrolled even though it has not gotten smaller.

Finally, he said, recognizing the importance of stable disease simplifiestreatment decision making, because progressive disease is easier to identifythan responses. "Patients can be treated purely on the premise thatyou change treatment when progression is diagnosed."