scholarly journals Prognostic factors for early relapse in non-metastatic triple negative breast cancer — real world data

2021 ◽  
Author(s):  
Rita Félix Soares ◽  
Ana Rita Garcia ◽  
Ana Raquel Monteiro ◽  
Filipa Macedo ◽  
Tatiana Cunha Pereira ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Triple Negative Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Real World Data ◽  
Early Relapse ◽  
World Data

Practice patterns of platinum chemotherapy use in a population-based cohort of women with nonmetastatic triple-negative breast cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18590-e18590
Author(s):  
Tess King ◽  
Catherine R. Fedorenko ◽  
Li Li ◽  
Rachel Lynn Yung
Keyword(s):  
Breast Cancer ◽  
Triple Negative Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Practice Patterns ◽  
Early Stage ◽  
Stage I ◽  
Complication Rates ◽  
Breast Cancer Patients ◽  
Real World Data

e18590 Background: The use of platinum agents (PT) in neoadjuvant chemotherapy (CTX) for triple negative breast cancer (TNBC) has been debated in research and practice guidelines. In high risk patients, the addition of PT to standard anthracycline and taxane regimens improves pathological complete response without definitive evidence of survival benefit (Korde JCO 2021). Due to PT’s toxicities and unclear benefit in early stage breast cancer, this study aimed to elucidate the real world practice patterns of PT use and overuse in breast cancer patients. Methods: The cohort was defined as women with stage I-III TNBC (ER, PR, and Her2 negative) who received curative intent surgery between 2011-2018. We utilized the Hutchinson Institute for Cancer Outcomes Research (HICOR) database, which links enrollment and claims records from commercial and public health insurance plans with clinical information from Washington state cancer registries (Manohar JACR 2020). We hypothesized there was overuse of PT CTX in this cohort. Overuse was defined as PT use in stage I, in the adjuvant period (NCCN 2020), and in nonstandard CTX regimens (PT use without taxane and anthracycline (NCCN 2020)). Results: Of the 910 women in the cohort, average age was 63, 90% were white, 682 (75%) received CTX, and 36% had commercial insurance, versus 53% with public insurance (Medicare 45%, Medicaid 8%). Of those receiving CTX, 39% received neoadjuvant and 67% adjuvant. Of those receiving CTX, 85 (13%) received PT, and 28 (4%) received PT without anthracycline. Of those receiving PT, 20% had stage I disease, and of those receiving adjuvant CTX, 43 (9%) received PT in the adjuvant period. Conclusions: We found there was overuse and nonstandard use of PT in this real world data. This overuse was demonstrated by the fact that 20% of women receiving PT had low risk stage I disease, and 9% of women receiving adjuvant CTX received PT in the adjuvant period. Additionally, there was nonstandard use, with 4% of women getting CTX receiving PT without anthracycline. Next steps in this research are to evaluate factors influencing overuse and nonstandard use, as well as complication rates with PT use and overuse.[Table: see text]

Real-world data regarding the efficacy of neoadjuvant carboplatin-paclitaxel followed by dose-dense adriamycin-cyclophosphamide for triple-negative early breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12559-e12559
Author(s):  
Ajay Ashok Bhojwani ◽  
Helen Flint ◽  
Benjamin James Hall ◽  
Helen Wong ◽  
Helen Innes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Real World ◽  
Triple Negative ◽  
Patient Choice ◽  
Real World Data ◽  
World Data ◽  
Surgery Outcome ◽  
Post Surgery ◽  
Platinum Based Chemotherapy ◽  
Clinical Records

e12559 Background: Platinum based regimens in the neoadjuvant (NA) setting for triple negative breast cancer (TNBC) have resulted in a significant increase in the pathological response (pCR) rate but at the cost of worse hematological toxicities. Despite these data such NA regimens are not widely used as yet for TNBC. Currently, no real world evidence exist regarding the efficacy and toxicity of this treatment regimen. Methods: Patients treated with neoadjuvant carbo-pac-ddAC between December 2015 and May 2018 at Clatterbridge Cancer Centre NHS Foundation Trust were identified via pharmacy records. Clinical records were reviewed, and clinico-pathological information and toxicity data were recorded. Data lock was January 16, 2019. Results: 53 female patients were identified with a median age of 48 years (IQR: 40.0-55.5). At presentation: Median tumour size 29mm (IQR: 20.0-40.0), 45% (24/53) were LN +, 8% (4/53) were ER+. Of 30 patients tested for germ line susceptibility, 23% (7/30) were found to have a BRCA mutation (full details to be presented). Delivery of planned CT : 4% (2/53) discontinued early for progressive disease or patient choice; of the remaining patients there were a total of 36 deferrals and 8 dose reductions. Surgical details: Breast: 42% (22/53) mastectomy & 58% (31/53) WLE, Ax management: 37% (19/51) Ax clearance & 63% (32/51) sentinel node biopsy (2 patients underwent previous axillary treatment for prior BC). Of 24 patients LN+ at presentation 58% (14/24) underwent Ax clearance; of these 64% (9/14) had no Ax involvement. pCR rate (ypT0/is, N0) (cases with prior ipsilateral Ax surgery excluded) was 53% (27/51) & pCR breast alone: 60% (31/52). Radiotherapy: 90% (47/52) received radiotherapy post-surgery. Outcome: At a median follow up 42.4 wks (IQR: 34.2-54.4), 6% (3/52) patients had disease recurrence resulting in 2 deaths. Conclusions: These initial real world data confirm the efficacy of NA therapy with carbo-pac-ddAC, with pCR rates consistent with literature. These results support the use of platinum based chemotherapy in the NA management of TNBC. Updated outcomes will be presented based on pCR versus no pCR; and BRCA status.

308 Triple-negative Breast Cancer – Which Classical Prognostic Factors Can Help in Identifying Patients with Early Relapse?

2012 ◽  
Vol 48 ◽  
pp. S132
Author(s):  
S. Susnjar ◽  
M. Milovic-Kovacevic ◽  
A. Karaferic ◽  
L.J. Stamatovic ◽  
D. Gavrilovic ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Early Relapse

scholarly journals Role of locoregional surgery in patients with de novo stage IV breast cancer: analysis of real-world data from China

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Li Ma ◽  
Yunzhe Mi ◽  
Shude Cui ◽  
Haibo Wang ◽  
Peifen Fu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Real World ◽  
Triple Negative ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Real World Data ◽  
World Data ◽  
Surgery Group ◽  
Stage Iv Breast Cancer

Abstract Stage IV breast cancer is metastatic breast cancer (MBC). Because real-world data are lacking in China, our research attempts to explore the effect of locoregional surgery on the prognosis of patients with MBC. A total of 987 patients from 10 hospitals and 2 databases in East China (2004–2018) were included in this study. Overall, 47% of patients underwent locoregional surgery, and 53% did not. Surgeons tended to perform surgery on patients with small tumours (T1/T2), positive hormone receptor (HR) markers, and metastatic sites confined to a single organ and non-visceral sites (bone only/others) (each p < 0.05). Kaplan–Meier survival curves and the log-rank test showed that median survival was longer for patients who had locoregional surgery than for those who did not (45.00 vs. 28.00 months; p < 0.001). Patients who underwent surgery after systemic treatment had better survival than those who underwent surgery immediately (p < 0.001). In most subgroups, overall survival (OS) was significantly longer in the surgery group than in the no-surgery group (each p < 0.05), except for brain metastases and triple negative breast cancer. Therefore, we concluded that locoregional surgery for the primary tumour in MBC patients was associated with a marked reduction in risk of dying except for patients with brain metastases or triple-negative subtype.

scholarly journals Androgen receptor expression in triple negative breast cancer and its relationship to prognostic factors

2017 ◽  
Vol 27 (3) ◽  
pp. 199-205
Author(s):  
Maximiliano Cassilha Kneubil ◽  
◽  
Alessandra Eifler Guerra Godoy ◽  
Guilherme Portela Coelho ◽  
Rafael Grochot ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Androgen Receptor ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Receptor Expression ◽  
Androgen Receptor Expression

Real-world cost-effectiveness of pertuzumab (P) with trastuzumab + chemo (T+Chemo) in patients (pts) with metastatic breast cancer (MBC): A population-based retrospective cohort study by the Canadian Real-world Evidence for Value in Cancer Drugs (CanREValue) collaboration.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 1048-1048
Author(s):  
Wei Fang Dai ◽  
Jaclyn Marie Beca ◽  
Chenthila Nagamuthu ◽  
Ning Liu ◽  
Maureen E. Trudeau ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Real World ◽  
Retrospective Cohort ◽  
Health Technology ◽  
Population Based ◽  
Net Benefit ◽  
Real World Data ◽  
World Data

1048 Background: Addition of P to T+chemo for MBC pts has been shown to improve overall survival (OS) in a pivotal randomized trial (hazard ratio [HR] = 0.66, 95% CI: 0.52, 0.84) (Baselga et al., NEJM 2012). In Canada, the manufacturer submission to the health technology assessment agency estimated that P produced 0.64 life years gained (LYG) with an incremental cost-effectiveness ratio (ICER) of $187,376/LYG over 10 years (CADTH-pCODR, 2013). This retrospective cohort analysis aims to determine the comparative real-world population-based effectiveness and cost-effectiveness of P among MBC pts in Ontario, Canada. Methods: MBC pts were identified from the Ontario Cancer Registry and linked to the New Drug Funding Program database to identify receipt of treatment between 1/1/2008 and 3/31/2018. Cases received P-T-chemo after universal public funding of P (Nov 2013) and controls received T-chemo before. Demographic (age, socioeconomic, rurality) and clinical (comorbidities, prior adjuvant treatments, prior breast cancer surgery, prior radiation, stage at diagnosis, ER/PR status) characteristics were identified from linked admin databases balanced between cases and controls using propensity score matching. Kaplan-Meier methods and Cox regressions accounting for matched pairs were used to estimate median OS and HR. 5-year mean total costs from the public health system perspective were estimated from admin claims databases using established direct statistical methods and adjusted for censoring of both cost and effectiveness using inverse probability weighting. ICERs and 95% bootstrapped CIs were calculated, along with incremental net benefit (INB) at various willingness-to-pay values using net benefit regression. Results: We identified 1,823 MBC pts with 912 cases and 911 controls (mean age = 55 years), of which 579 pairs were matched. Cases had improved OS (HR = 0.66; 95% CI: 0.57, 0.78), with median 3.4 years, compared to controls median OS of 2.1. P provided an additional 0.63 (95% CI: 0.48 – 0.84) LYG at an incremental cost of $196,622 (95% CI: $180,774, $219,172), with a mean ICER = $312,147/LYG (95% CI: $260,752, $375,492). At threshold of $100,000/LYG, the INB was -$133,632 (95% CI: -$151,525, -$115,739) with < 1% probability of being cost-effective. Key drivers of incremental cost increase between groups included drug and cancer clinic costs. Conclusions: The addition of P to T-chemo for MBC increased survival but at significant costs. The ICER based on direct real-world data was higher than the initial economic model due to higher total costs for pts receiving P. This study demonstrated feasibility to derive ICER from person-level real-world data to inform cancer drug life-cycle health technology reassessment.

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