Compared to intermittent chemotherapy, continuous scheduling is associated with improved survival and similar quality of life (QoL) in patients with advanced HER2-negative breast cancer (BCa), according to analyses of the Stop & Go study presented at the ESMO Breast Cancer congress 2019.
The phase 3 randomised study (n=420) compared intermittent (four cycles - treatment holiday - four cycles) or continuous chemotherapy (eight consecutive cycles). First-line treatment was paclitaxel plus bevacizumab, and second-line treatment was capecitabine or non-pegylated liposomal doxorubicin.
For patients who started second-line study treatment (n=270; 131 vs. 139 in intermittent vs. continuous arm), median progression-free survival (PFS) in second-line was 3.5 vs. 5.0 months (hazard ratio [HR] 1.04; 95% CI 0.69-1.57) and median overall survival (OS) in second-line was 10.6 vs. 12.0 months (HR 1.64; 95% CI 1.08-2.48). Median combined first- and second-line PFS was 14.6 vs. 16.6 months (HR 1.59; 95% CI 1.04-2.45) and median OS was 20.3 vs. 23.0 months (HR 1.93; 95% CI 1.26-2.95).
A separate study assessed QoL with intermittent vs continuous scheduling. Physical QoL declined linearly in the intermittent arm causing a clinically meaningful difference of 5.68 points at 24 months (P<.001 while scores in the continuous arm stabilised after a decline of points at months.>