Bone targeting agent treatment patterns and the impact of bone metastases on patients with advanced breast cancer in the US.

93 Background: Bone is the most common site of distant metastasis in patients with advanced breast cancer. Bone metastases (BMs) often lead to skeletal-related events (SREs) and may result in debilitating bone pain which impacts a patient’s quality of life. Bone targeting agents (BTAs) reduce the incidence of SREs and progression of pain due to BMs. This study aims to understand real world patients’ experience of bone pain and to assess BTAs treatment patterns. Methods: Data were extracted from the Adelphi Breast Cancer Disease-Specific Programme (DSP), a cross-sectional survey of 98 US oncologists conducted from February to May 2015 in the USA. Each physician completed comprehensive record forms capturing the following information about the next 12 patients being treated for advanced breast cancer: Presence of BMs, patient’s pain state at diagnosis of BMs, current pain state, time since diagnosis of BMs, current analgesic use and reasons for prescribing BTAs. Results: Bone pain was more prevalent (p < 0.001) in patients with BMs (67% of 485) than those without BM (7% of 791). Mean time for pain assessment was 6.2 months after BM diagnosis. Among breast cancer patients with BMs and bone pain (n = 323), 98% required analgesic medications to manage the pain, including 40% (n = 130) who were treated with strong opioids (e.g., morphine, oxycodone, hydromorphone, or methadone). Of these patients, 100 (77%) had moderate/severe bone pain. Of the patients with BMs, 69% (n = 337) were treated with a BTA and treatment was initiated within 3 months of BMs diagnosis in 91% (n = 306) of them. The reasons for prescribing a BTA within 3 months of BM diagnosis were “bone pain” (32%), “high risk of bone complications” (25%), “prior history of bone complications”(18%), “number of BMs” (11%) and “location of BMs” (4%). Conclusions: Advanced breast cancer patients with BMs are more likely to experience bone pain, and three-fourths of the patients treated with strong opioids experienced moderate/severe bone pain.The majority of patients with BMs receive a BTA prescription for the reduction of bone pain and risk of bone complications.

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1523 Bone Targeting Agent (BTA) treatment patterns and the impact of Bone Metastases (BMs) on advanced breast cancer patients in a real world setting

European Journal of Cancer ◽

10.1016/s0959-8049(16)30613-x ◽

2015 ◽

Vol 51 ◽

pp. S211-S212

Author(s):

R. Von Moos ◽

D. Henry ◽

J.J. Body ◽

A. Rider ◽

J. De Courcy ◽

...

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Bone Metastases ◽

Cancer Patients ◽

Real World ◽

Treatment Patterns ◽

Breast Cancer Patients ◽

Bone Targeting ◽

Real World Setting ◽

The Impact

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Real-world treatment patterns among advanced HR+/HER2- breast cancer patients in the post-CDK4/6 inhibitor era: An analysis of administrative claims data.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e18695 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e18695-e18695

Author(s):

Tirza Areli Calderón Boyle ◽

Soham Shukla ◽

Lindsey Powers Happ ◽

Shan Zheng ◽

Boris Gorsh

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Real World ◽

Claims Data ◽

Advanced Disease ◽

Treatment Patterns ◽

Advanced Breast ◽

Breast Cancer Patients ◽

Her2 Breast Cancer ◽

Over Time

e18695 Background: The treatment paradigm for advanced HR+/HER2- breast cancer has been rapidly evolving since the approval of the first CDK4/6 inhibitor in the U.S. in 2015. Available literature on real-world utilization of various treatment options available to these patients remains limited. The objective of this study was to describe how advanced HR+/HER2- breast cancer treatment patterns have changed over time since the approval of novel CDK4/6 inhibitors. Methods: IBM MarketScan Research Databases, a nationally representative source of U.S. insurance claims data, was used to identify women diagnosed with advanced breast cancer between January 2015 and December 2019 via ICD-9/10 codes. Algorithms were applied to capture patients with HR+/HER2- subtype and advanced disease diagnosis. Patients were indexed on their advanced breast cancer diagnosis date and were required to have six months continuous enrollment in the insurance claims database prior to and after the index date to ensure patients included in the cohort were alive and contributed at least 12 months of data for analysis. Lines of therapy (LOTs) were constructed and treatment patterns were reported over time. Descriptive analyses were conducted using Instant Health Data software. Results: A total of 4,128 women (mean age: 58 years, IQR: 50-64 years) had received at least one systemic breast cancer treatment and were included in the analysis. During a mean follow-up time of two years, nearly 29% of patients received at least four LOTs for advanced disease. A high number of unique regimens were reported in each LOT (30 in 1L, 48 in 2L, 53 in 3L and 50 in 4L+). The distribution of the top 1L regimens changed significantly over time (Table). CDK4/6 inhibitor use in the 2L setting also increased substantially from 43% in 2015 to 68% in early 2019, while chemotherapy and endocrine monotherapy utilization decreased. Conclusions: These data reflect a significant shift in the treatment landscape for HR+/HER2- advanced breast cancer patients in real-world practice since the availability of CDK4/6 inhibitors. However, there remains significant heterogeneity in the use of other treatments in these patients and in treatment sequencing, suggesting potential unmet need with current therapies. Further insight into patient, clinical and community-level factors guiding treatment decisions in the real world is needed. [Table: see text]

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