336P - Patterns of clinical management and resource utilization for postmenopausal hormone-receptor-positive HER2-negative (HR+ HER2-) advanced breast canc...

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Bioethics, Legal, and Economic Issues
Breast Cancer
Presenter Guy Jerusalem
Authors G. Jerusalem1, N. Marinsek2, J. Ricci3, J. Etchberger2, R. Degun2, G. Benelli4, S. Saletan5, F. André6
  • 1Centre Hospitalier Universitaire Du Sart Tilman, Centre Hospitalier Universitaire du Sart Tilman, Liège/BE
  • 2Navigant Consulting, Inc, Navigant Consulting, Inc, London/UK
  • 3Wellmera Ag, Wellmera AG, Basel/CH
  • 4Novartis Farma S.p.a., I-21047, Novartis Farma S.p.A., I-21047, Saronno / VA/IT
  • 5Onco Ex Dir Clinical Res Phys, Novartis Pharmaceuticals Corporation, East Hanover/US
  • 6Breast Cancer Unit, Department Of Medical Oncology, Institut Gustave Roussy, 94800 - Villejuif/FR



To understand treatment patterns and quantify resource utilization of HR+ HER2 aBC, with the overall aim of comparing costs and disease burden as patients progress from hormonal therapy (HT) to chemotherapy (CT).


We conducted a chart audit in France, Germany, The Netherlands, Belgium, and Sweden of 375 living and deceased postmenopausal female patients (75 per country) diagnosed with ER+ HER2 aBC in the past 4 years. Patients were required to have progressed on ≥ 1 line of prior HT either in the adjuvant or advanced setting and to have completed ≥ 1 line of CT treatment (minimum 2 full cycles) in the aBC setting. The chart audit was completed online using a standardized form developed with the assistance of European academic physicians, pharmacy directors, and hospital administrators. Participation was sought from 25 oncologists per country, except in Germany (15 oncologists and 10 gynecologists to reflect local clinical practice). Data collection was compliant with European and country market research regulations.


Our report details the patient care pathway, CT side effects, and resource utilization in the inpatient and outpatient settings throughout the continuum of aBC care. Preliminary analyses indicate that 55% of HR+ HER2 aBC patients are first treated with HT and switch to CT after 1.5 lines of HT. This switch is primarily influenced by the extent (56%) and progression rate (36%) of metastases. The switch from HT to CT is associated with increased resource utilization and the associated costs of treating aBC. In addition to cost of drug therapies, the main drivers of cost are treatment for CT side effects (chiefly febrile neutropenia and diarrhea) and related hospitalization events. CT side effects that have the greatest impact on the overall disease burden of aBC include alopecia, nausea, vomiting, fatigue, and peripheral neuropathy.


Our results highlight the increased costs and disease burden for postmenopausal ER+ HER2 aBC patients treated with CT versus HT.


G. Jerusalem: Consultant, Novartis Pharmaceuticals Corporation.

N. Marinsek: Consultant, Novartis Pharmaceuticals Corporation.

J. Ricci: Advisor, consultant, Novartis Pharmaceuticals Corporation.

J. Etchberger: Consultant, Novartis Pharmaceuticals Corporation.

R. Degun: Consultant, Novartis Pharmaceuticals Corporation.

G. Benelli: Employees of Novartis with stock/stock options.

S. Saletan: Employee of Novartis with stock/stock options.

F. André: Financial support from sanofi-aventis, Novartis, Roche, AstraZeneca