Characteristics, treatment and survival of older patients with metastatic triple negative breast cancer from the ESME mBC real-world national cohort: a comparison with younger women

INTRODUCTION: Metastatic triple-negative breast cancer (mTNBC) remains a major therapeutic challenge, particularly among older women, who are frequently underrepresented in clinical trials. This study aimed to describe the characteristics, treatment patterns, and prognostic factors for real-world progression-free survival (rwPFS) and overall survival (OS) in older (≥70 years) women with metastatic TNBC (mTNBC) compared to younger women. (40-69 years) METHODS: A retrospective analysis of the UNICANCER ESME cohort was conducted, including 4246 women diagnosed with mTNBC between 2008 and 2021. Patient demographics, tumor characteristics, treatment data, and survival outcomes were collected. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess OS and rwPFS. RESULTS: Older women (n = 987) presented with less aggressive tumors and were less likely to receive chemotherapy or targeted therapy compared to younger women (n = 3259). Median OS was 13.7 months in older women and 15.8 months in younger women, with no significant difference. Prognostic factors for OS and rwPFS included the number of metastatic sites, visceral metastasis, and metastasis-free interval, regardless of age. In older women, age over 80 was associated with poorer prognosis. CONCLUSION: Despite differences in treatment patterns, survival outcomes were comparable between older and younger women with mTNBC. This real-world analysis underscores the importance of studying mTNBC in older populations, who are often excluded from clinical trials. Further research is needed to optimize treatment strategies for older women with mTNBC, especially with the introduction of new therapies and considering the real world data that allows for a better understanding of this population.