Time-varying hazard rates reveal patterns of progression in HR+/HER2- metastatic breast cancer: Towards risk-adapted monitoring.

Linda Cucciniello; Fabiola Giudici; Lorenzo Foffano; Alessandra Franzoni; Brenno Past&#xf2;; Elisabetta Molteni; Serena Della Rossa; Gaetano Pascoletti; Simon Spazzapan; Lorena Musco; Gabriele Di Giustino; Lucia Da Ros; Riccardo Vida; Elena Poletto; Elena Nascimbeni; Marta Bonotto; Alessandro Marco Minisini; Barbara Belletti; Giuseppe Damante; Lorenzo Gerratana; Fabio Puglisi

doi:10.1016/j.tranon.2026.102960

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Time-varying hazard rates reveal patterns of progression in HR+/HER2- metastatic breast cancer: Towards risk-adapted monitoring.

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Abstract

BACKGROUND: optimal imaging intervals for patients with hormone receptor-positive/HER2-negative metastatic breast cancer (MBC) remains undefined. Aim of this study was to analyze the temporal patterns of disease progression to identify high risk subgroups that may benefit from intensified monitoring. METHODS: we analyzed 149 hormone receptor-positive/HER2-negative MBC patients prospectively enrolled in the MAGNETIC.1 trial (NCT05814224) and treated with first line endocrine therapy. Hazard rates (HR) for disease progression were determined according to clinico-pathological and liquid biopsy features. RESULTS: in the overall population, two distinct progression-risk peaks emerged at 2-3 months (32.9/1000 person-months) and at 24 months (28.0/1000). Higher risk of progression was observed in lobular carcinoma (61.1) [HR 61.12 per 1000 person month (pm)], progesterone receptor-negative status (HR 39.07), fulvestrant-based treatment (HR 46.88), liver metastases (HR 59.00), and presence of ≥ 3 metastatic sites (HR 40.10). CONCLUSIONS: Hazard distribution in hormone receptor-positive/HER2-negative MBC is biphasic and modulated by readily available clinical variables. High-risk subgroups may benefit from intensified radiologic and liquid-biopsy surveillance during the first three months and around two years after treatment start.

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Linda Cucciniello, Fabiola Giudici, Lorenzo Foffano, Alessandra Franzoni, Brenno Pastò, Elisabetta Molteni, Serena Della Rossa, Gaetano Pascoletti, Simon Spazzapan, Lorena Musco, Gabriele Di Giustino, Lucia Da Ros, Riccardo Vida, Elena Poletto, Elena Nascimbeni, Marta Bonotto, Alessandro Marco Minisini, Barbara Belletti, Giuseppe Damante, Lorenzo Gerratana, Fabio Puglisi. 2026-07-28. Time-varying hazard rates reveal patterns of progression in HR+/HER2- metastatic breast cancer: Towards risk-adapted monitoring.. https://doi.org/10.1016/j.tranon.2026.102960

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