Chemo Does Not Improve Long-Term Outcomes in Early-Stage ILC

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Chemotherapy does not improve long-term survival outcomes in patients with early-stage invasive lobular carcinoma (ILC), according to a meta-analysis published in Clinical Breast Cancer.

The meta-analysis authors noted that ILCs typically respond poorly to chemotherapy. However, the long-term survival advantage of prescribing chemotherapy to ILC patients has been unclear.

To assess the impact of chemotherapy on long-term disease-free (DFS) and overall survival (OS), the researchers analyzed data from 9 studies across several countries. 

The studies included a total of 28,218 patients, and the mean follow-up was 74 months. Overall, 34.7% of patients were treated with chemotherapy, and 66.3% were not.

The 10-year DFS rate was higher in the chemotherapy group than in the no-chemotherapy group — 83.4% and 80.3%, respectively (P =.001). 

However, in an adjusted analysis, there was no significant difference in 10-year DFS between the chemotherapy and no-chemotherapy groups (odds ratio [OR], 0.89; 95% CI, 0.65-1.23; I=83%). 

Similarly, there was no significant difference in 10-year OS between the chemotherapy and no-chemotherapy groups in an adjusted analysis (OR, 0.92; 95% CI, 0.72-1.18; I=89%). 

In an unadjusted analysis, the 10-year OS rate was 76.3% in the chemotherapy group and 75.9% in the no-chemotherapy group (P =.563).

“The most important finding in this meta-analysis is the data illustrating that there is no survival advantage associated with prescribing systemic chemotherapies in the setting of localized ILC,” the study authors concluded. “These results are of the utmost importance within the current breast cancer management paradigm, as there is currently a paucity of expert consensus statements or guidelines providing recommendations for optimizing systemic chemotherapy use in ILC.”

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