Real-world treatment patterns and outcomes in patients with HR+/HER2− metastatic breast cancer treated with chemotherapy in the United States Journal Article


Authors: Tolaney, S. M.; Punie, K.; Carey, L. A.; Kurian, A. W.; Ntalla, I.; Sjekloca, N.; Shah, A.; Rehnquist, M. K.; Stokes, M.; Fraeman, K.; Verret, W.; Jhaveri, K.
Article Title: Real-world treatment patterns and outcomes in patients with HR+/HER2− metastatic breast cancer treated with chemotherapy in the United States
Abstract: Background: Until recently, treatment options for patients with hormone receptor-positive/human epidermal growth factor 2-negative (HR+/HER2−) metastatic breast cancer (mBC) and resistance to endocrine therapy were limited to chemotherapy. This real-world study describes treatment patterns and outcomes in patients treated with chemotherapy in the United States before approval of antibody–drug conjugates. Patients and methods: This retrospective, observational study included adults with HR+/HER2− mBC from the ConcertAI Patient360TM Breast Cancer dataset who initiated their first chemotherapy in the metastatic setting between January 2011 and June 2021. Treatment patterns were described; real-world overall survival, time to next treatment or death, and real-world progression-free survival were evaluated for all eligible patients and patients treated with subsequent chemotherapy. Index dates were the start date of each chemotherapy treatment. Results: Among 1545 eligible patients, 76% were white, 12% had Eastern Cooperative Oncology Group performance status ≥2, 38% had de novo mBC, and median age was 61 years (range, 52-69 years). Within the index period, capecitabine was used the most as the first chemotherapy agent and decreased in later treatments, while the use of eribulin increased between first and fourth chemotherapies. Median (95% confidence interval) real-world overall survival was 23.3 months (21.3-25.4 months) from start of first chemotherapy, time to next treatment or death was 6.5 months (5.9-7.1 months), and real-world progression-free survival was 6.9 months (6.4-7.6 months); median times from second, third, and fourth chemotherapies decreased with each additional chemotherapy treatment. Conclusions: This real-world study demonstrates that for patients with HR+/HER2− mBC, chemotherapy provides relatively limited survival benefit which decreases with each additional chemotherapy line, and highlights the need for improved treatment options. © 2024 The Authors
Keywords: adult; cancer chemotherapy; cancer survival; controlled study; aged; survival rate; major clinical study; overall survival; cisplatin; doxorubicin; cancer combination chemotherapy; monotherapy; systemic therapy; united states; bone metastasis; capecitabine; gemcitabine; paclitaxel; cancer patient; chemotherapy; lymph node metastasis; carboplatin; progression free survival; cohort analysis; cyclophosphamide; retrospective study; docetaxel; cancer hormone therapy; survival time; liver metastasis; lung metastasis; brain metastasis; epirubicin; visceral metastasis; observational study; mammalian target of rapamycin inhibitor; metastatic breast cancer; cyclin dependent kinase inhibitor; antineoplastic hormone agonists and antagonists; caucasian; ixabepilone; eribulin; phosphatidylinositol 3 kinase inhibitor; molecularly targeted therapy; clinical outcome; selective estrogen receptor modulator; time to treatment; hormone receptor-positive; human; male; female; article; vinorelbine tartrate; ecog performance status; antibody drug conjugate; sacituzumab govitecan; her2-negative; hormone receptor-positive, her2-negative breast cancer; antibody–drug conjugates; line of treatment; gemcitabine plus paclitaxel; rwe
Journal Title: ESMO Open
Volume: 9
Issue: 9
ISSN: 2059-7029
Publisher: European Society for Medical Oncology  
Date Published: 2024-09-01
Start Page: 103691
Language: English
DOI: 10.1016/j.esmoop.2024.103691
PROVIDER: scopus
PMCID: PMC11406087
PUBMED: 39241499
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- Source: Scopus
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  1. Komal Lachhman Jhaveri
    201 Jhaveri