Late lines of treatment benefit survival in metastatic breast cancer in current practice?

Metastatic breast cancer is mostly incurable. Progressively overall survival (OS) has improved but few authors have studied treatment globally versus for each line and demonstrated the interest of chemotherapy (CT) after the third line. We selected recent patients treated during the “taxane/anti-aromatase era” for each line given. 529 received CT and 383 hormonotherapy. OS was assessed; from the date of first metastasis and from Day 1 of each CT line. Median OS was 34.1 months; 226 patients received >3 lines of CT with a steady median OS for late lines, 11.4 months per line (range 10.4–12.6). Clinical benefit after the third line of CT was obtained for 29.2–36.6% of patients. CT lasted 11.7 months “on” versus 20.6 months “off” CT. These results may support the use of more than 3 CT lines; each line can contribute to a longer survival.