Systemic treatment in advanced phyllodes tumor of the breast: a multi-institutional European retrospective case-series analyses

Background We aimed at investigating outcome of systemic treatments in advanced breast PT. Methods All cases of advanced breast PT treated with systemic treatments from 1999 to 2019, in one of the referral sarcoma centers involved in the study, were retrospectively reviewed. Results 56 female patients were identified. Median age was 52 (range of 25–76) years. Patients received a median number of 2 systemic treatments (range of 1–4). Best responses according to RECIST were 1 (3.7%) CR, 11 (40.7%) PR, 6 (22.2%) SD, 9 (33.3%) PD with anthracyclines plus ifosfamide (AI); 2 (16.7%) PR, 4 (33.3%) SD, 6 (50.0%) PD with anthracycline alone; 3 (18.8%) PR, 4 (25.0%) SD, 9 (56.3%) PD with high-dose ifosfamide given as a continuous infusion (HD-IFX); 3 (20.0%) SD, 12 (80.0%) PD with a gemcitabine-based regimen (with 2 patients not evaluable); 1 (8.3%) PR, 2 (16.7%) SD, 9 (75.0%) PD with trabectedin (with 1 patient not evaluable); 1 (16.7%) PR, 1 (16.7%) SD, 4 (66.7%) PD with tyrosine-kinase inhibitors (TKI). The median PFS were 5.7 (IQR 2.5–9.1) months with AI; 3.2 (IQR 2.2–5.0) months with anthracycline alone; 3.4 (IQR 1.4–6.7) months with HD-IFX; 2.1 (IQR 1.4–5.2) months with gemcitabine-based chemotherapy; 1.8 (IQR 0.7–6.6) months with trabectedin; 3.4 (IQR 3.1–3.8) months with TKI. With a median follow-up of 35.3 (IQR 17.6–66.9) months, OS from the start of first-line systemic treatment was 15.2 (IQR 7.6–39.6) months. Conclusion In this series of advanced PT (to our knowledge, the largest reported so far), AI was associated with a high rate of responses, however, with a median PFS of 5.7 months. Other systemic treatments were poorly active.