Abstract P3-07-09: Prevalence and effects of off-label use of chemotherapeutic agents in elderly breast cancer patients: estimates from Surveillance, Epidemiology and End Results-Medicare data

2012 ◽  
Author(s):  
AA Eaton ◽  
CS Sima ◽  
KS Panageas
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Chemotherapeutic Agents ◽  
Breast Cancer Patients ◽  
Off Label Use ◽  
Off Label ◽  
Medicare Data ◽  
End Results ◽  
Label Use

Prescription trends of everolimus in non-elderly cancer patients with private insurance in the United States.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18016-e18016
Author(s):  
Yan Xing ◽  
Ying Xu ◽  
Funda Meric-Bernstam ◽  
Jenny Chee Ning Chang ◽  
Ya-Chen T. Shih
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Renal Cancer ◽  
Private Insurance ◽  
The United States ◽  
Secondary Malignancies ◽  
Off Label Use ◽  
Elderly Cancer Patients ◽  
Off Label ◽  
Label Use

e18016 Background: The use of targeted oral cancer medications has increased significantly since 2001. Everolimus, an mTOR inhibitor was first approved for cancer treatment by FDA as second line for patients with advanced renal cancer. Subsequently it has been approved for advanced pancreatic neuroendocrine tumor (NET) in 2011 and breast cancer in 2012 respectively. Off-label use is common in oncology practice. The objective of this study is to assess prescription trends, especially off-label use of everolimus, among non-elderly cancer patients with private insurance in the United States from 2009 to 2014. Methods: Data from the MarketScan database were analyzed. Between 2009 to 2014, 4,728 cancer patients with at least one everolimus prescription were included in the analyses. The diagnosis which incurred the most recently to the initial everolimus use in each calendar year was recorded. Off-label use was defined as using everolimus by all of the cancer types except of renal cancer in 2009-2014, NET in 2011-2014 and breast cancer in 2012-2014. Results: The number of patients received everolimus has increased significantly from 243 in 2009 to 1,194 in 2014. The most common diagnoses associated with everolimus use were breast cancer (42%), followed by renal cancer (24%), and NET (7%). Off-label use of everolimus increased from 29% in 2009 to 47% in 2011 then decreased to 23% in 2014. The 3 most common diagnoses associated with off-label use of everolimus were secondary malignancies (30.7%), breast cancer (10.4%) and liver cancer (5%) in 2009-2011, compared to secondary malignancies (47.3%), brain cancer (4.2%) and lung cancer (3.9%) in 2012-2014. The off-label use in female has decreased significantly from 32% in 2009 to 19% in 2014 (p = 0.03). There was no statistical difference in off-label use of everolimus by geographic region. Conclusions: Analyses of MarketScan data suggest off-label use of everolimus is common among US cancer patients, especially in lung, liver and brain cancer and secondary malignancies after the approved indication was expanded to breast cancer in 2012. Further research of the factors associated with off-label use of everolimus and its economic implication is needed.

Off-label drug use in women with breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 1016-1016
Author(s):  
W. Dean-Colomb ◽  
S. Fang ◽  
W. Smith ◽  
L. Michaud ◽  
G. N. Hortabagyi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast ◽  
Scientific Data ◽  
Supporting Evidence ◽  
Breast Cancer Patients ◽  
Off Label Use ◽  
Off Label ◽  
Chemotherapy Drugs ◽  
Number Of Patients ◽  
Label Use

1016 Background: Despite reports of widespread use of off-label agents in cancer treatment, little is known about the off-label use of agents in the treatment of breast cancer patients. Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) - Medicare linked database to identify 2082 persons older than 65 years who were diagnosed with distant stage breast cancer between 1991 and 2002 and who were treated with chemotherapy between diagnosis and death. Off versus on-label classification was based upon FDA-approved indication in the treatment of breast cancer. We calculated the percentage of patients receiving off-label chemotherapy and used multivariate logistic regression models to estimate predictors of off-label chemotherapy use. We also evaluated the appropriateness of off-label chemotherapy drugs using DRUGDEX classifications. Results: Overall, 34.9% of patients were treated with off-label chemotherapy drugs. Of the thirty-six agents that were used to treat these patients, only 8 (22%) were FDA-approved for use in the treatment of breast cancer. Off-label use was least common in patients age 80 years and older (OR 1.93, 95% 1.35–2.76 for 80+ vs. 66–70 years) and varied by diagnosis year and geographic region. The most commonly used off-label agents were vinorelbine and gemcitabine, with 16.0% and 8.4% of patients receiving these agents, respectively. While 71% of the drugs used off-label lacked supporting evidence for their use in the treatment of breast cancer, these drugs were used in a small number of patients. Only 6.7% of patients were treated with drugs considered inappropriate for use in the treatment of breast cancer. Conclusions: Off-label chemotherapy use is widespread among patients with metastatic breast cancer. However, the majority of patients who received off-label chemotherapy received drugs with scientific data supporting such use. No significant financial relationships to disclose.

scholarly journals Chinese Herbal Medicine for Reducing Chemotherapy-Associated Side-Effects in Breast Cancer Patients: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 10 ◽  
Author(s):  
Sha Li ◽  
Tsz-him So ◽  
Guoyi Tang ◽  
Hor-Yue Tan ◽  
Ning Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Side Effects ◽  
Herbal Medicine ◽  
Cancer Patients ◽  
Chinese Herbal Medicine ◽  
Meta Analysis ◽  
Chemotherapeutic Agents ◽  
Breast Cancer Patients ◽  
Chinese Herbal

BackgroundChemotherapy usually induces a variety of side-effects in cancer treatment as it cannot tell normal cells apart from cancer cells and kills both. Chinese herbal medicine (CHM) has been regarded as a potential effective intervention for relieving the side-effects of chemotherapy in breast cancer patients.ObjectiveThis study aims to conduct a comprehensive systematic review and meta-analysis to evaluate the efficacy of CHM as adjuvant therapy for reducing the chemotherapy-induced side-effects in the treatment of breast cancer.MethodsMain electronic databases were searched up to May 2020 for Randomized Controlled Trials (RCTs) evaluating the effect of CHM on breast cancer patients with chemotherapy. The PRISMA statement was adopted in this study and meta-analyses were performed.ResultsThe included studies showed unsatisfied quality. Results based on available literature indicated that the adjunctive use of CHM with chemotherapy may reduce the chemotherapeutic agents-associated adverse events, including nausea and vomiting, diarrhea, alopecia, myelosuppression, and impaired immune function.ConclusionA confident conclusion could not be have due to the lack of large scale and high quality trials.

scholarly journals Off-label use of cancer therapies in women diagnosed with breast cancer in the United States

SpringerPlus ◽  
2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Sophie Hamel ◽  
Douglas S McNair ◽  
Nicholas J Birkett ◽  
Donald R Mattison ◽  
Anthony Krantis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
United States ◽  
The United States ◽  
Cancer Therapies ◽  
Off Label Use ◽  
Off Label ◽  
Label Use

Electrochemotherapy for cutaneous metastases in breast cancer: Experience from a designated treatment centre.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 48-48
Author(s):  
Shramana Mitul Banerjee ◽  
Jackie Newby ◽  
Shahab Khan ◽  
Virginia Homfray ◽  
Diane Whittaker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Progression ◽  
Cancer Patients ◽  
Chest Wall ◽  
Chemotherapeutic Agents ◽  
Post Treatment ◽  
Breast Cancer Patients ◽  
Cutaneous Metastases ◽  
Treatment Centre

48 Background: Electrochemotherapy (ECT) combines the administration of poorly permeable chemotherapeutic agents with electroporation. It has been shown to be effective when compared with other treatments. This study assessed how breast cancer patients were benefited and identified potential problems at a designated treatment centre. Methods: This was a single centre prospective study of patients with cutaneous metastases from breast cancer. Patients who fulfilled NICE UK (National Institute Of Clinical Excellence) and local guidelines were treated. Gabapentin was given prior to general anaesthesia. Intravenous Bleomycin 15,000IU/m2 was given as a bolus. Treatment was commenced 8 minutes later with Cliniporator. Electrical pulses were delivered via an electrode inserted through the skin surface. Treatment response, disease progression free duration, post-operative pain and length of in-patient stay (LOS) were recorded. Patients recorded a symptom diary post treatment. Results: 20 treatments were performed in 16 patients from 2011-2015 with 53 separate areas treated. 8 patients had diffuse lesions, 5 had discrete lesions and 3 had both diffuse and discrete areas. 16 patients were being treated with ECT for the first time and 4 patients required 2 treatments. Median LOS was 3 days. Median follow up was 6 months (range 3-12).12 patients had complete response (75%) and 4 patients partial response. There was no disease progression for 6 months or more in 9 patients (56%) and 2 further patients had disease stabilised for 3 months with systemic or cutaneous progression in the remaining patients in 3 months or less. There were no deaths or immediate adverse events from ECT. 5 Patients (31%) with extensive diffuse chest wall disease reported persistent discomfort post treatment requiring extended period of post treatment analgesia. Conclusions: Electrochemotherapy is safe and effective treatment for cutaneous metastases. Appropriate patient selection for treatment, pre-emptive analgesia, post treatment support and follow up is essential in order to maximise the benefits and minimise potential side-effects particularly in extensive chest wall disease.

scholarly journals Arterial Stiffness in Breast Cancer Patients Treated with Anthracycline and Trastuzumab-Based Regimens

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Özlem Yersal ◽  
Ufuk Eryilmaz ◽  
Hakan Akdam ◽  
Nezih Meydan ◽  
Sabri Barutca
Keyword(s):  
Breast Cancer ◽  
Cardiovascular Diseases ◽  
Arterial Stiffness ◽  
Pulse Wave Velocity ◽  
Cancer Patients ◽  
Wave Velocity ◽  
Pulse Wave ◽  
Chemotherapeutic Agents ◽  
Breast Cancer Patients

Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.

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