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Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

2904 - Comparative effectiveness of nab-paclitaxel vs. paclitaxel monotherapy as first-line (1L) treatment of metastatic triple-negative breast cancer (mTNBC) in US clinical practice

Date

22 Oct 2018

Session

Poster display session: Breast cancer - early stage, locally advanced & metastatic, CNS tumours, Developmental therapeutics, Genitourinary tumours - prostate & non-prostate, Palliative care, Psycho-oncology, Public health policy, Sarcoma, Supportive care

Presenters

Tricia Luhn

Citation

Annals of Oncology (2018) 29 (suppl_8): viii90-viii121. 10.1093/annonc/mdy272

Authors

T. Luhn1, S. Chui2, A. Hsieh3, J. Yi4, A. Mecke5, P. Bajaj6, W. Hasnain7, A. Falgas8, T.G.N. Ton9, A. Kurian10

Author affiliations

  • 1 Product Development, Genentech, Inc., 94080 - South San Francisco/US
  • 2 Product Development Oncology, Genentech, Inc., South San Francisco/US
  • 3 Center For Outcomes Research And Evaluation, Genentech, Inc., South San Francisco/US
  • 4 Epidemiology, Genesis Research, Hoboken/US
  • 5 Pdb Biostatistics, Roche, Basel/CH
  • 6 Health Economics, Genentech, Inc., 94080 - South San Francisco/US
  • 7 Global Pricing And Market Access, Genentech, Inc., 94080 - South San Francisco/US
  • 8 Pdr Department, Roche, Basel/CH
  • 9 Real World Data Oncology, Genentech, Inc., South San Francisco/US
  • 10 Medicine - Med/oncology, Stanford University School of Medicine, Stanford/US
More

Resources

Abstract 2904

Background

Taxanes are commonly used as a standard of care treatment for 1L mTNBC. Few studies have directly compared the effectiveness of nab-paclitaxel and paclitaxel in the real world setting, however. This study investigated the overall survival (OS) of nab-paclitaxel vs. paclitaxel as monotherapy in 1L treatment of mTNBC in routine practice.

Methods

A total of 200 patients in the Flatiron Health EHR-derived database were included based on a confirmed diagnosis of mTNBC from 1 Jan 2011 and 31 October 2016 and receipt of nab-paclitaxel or paclitaxel monotherapy as 1L treatment. The primary outcome, OS, was estimated by Kaplan-Meier methods and compared by the log-rank test and by univariate and multivariate Cox regression models. Time to next treatment (TTNT) was assessed as a secondary outcome.

Results

Compared with pts who received paclitaxel (n = 95), at baseline, those who received nab-paclitaxel (n = 105) were more likely to have been diagnosed at an earlier stage (I-III), have a treatment free ≤ 12 months (in pts with recurrent disease), adjuvant treatment with a taxane, a prior diagnosis of neuropathy and coverage by commercial healthcare insurance. Other characteristics were balanced between groups. Over 90% of pts with evaluable dosing data (179 of 195) received weekly doses of either taxane, with 100 mg/m2 as the most common dose for nab-paclitaxel and 80 mg/m2 for paclitaxel. Median OS was 11.2 months in pts treated with nab-paclitaxel and 10.8 months in paclitaxel-treated pts (log-rank P = 0.82). The OS hazard ratio (HR) from the adjusted Cox model was 0.90 (95% CI: 0.61, 1.32), indicating a similar risk of death between the two groups. The robustness of this result was confirmed in several sensitivity analyses. TTNT for nab-paclitaxel and paclitaxel was 4.7 and 4.3 months (log-rank P = 0.44), respectively, and did not differ in adjusted analyses (HR = 0.95 [95% CI: 0.65, 1.38]).

Conclusions

Nab-paclitaxel and paclitaxel monotherapy demonstrated similar outcomes, suggesting they may be considered interchangeable as 1L treatments for mTNBC.

Clinical trial identification

Legal entity responsible for the study

F. Hoffmann-La Roche AG.

Funding

F. Hoffmann-La Roche AG.

Editorial Acknowledgement

Editorial assistance was provided by Health Interactions.

Disclosure

T. Luhn, S. Chui, A. Hsieh, P. Bajaj, W. Hasnain, T.G.N. Ton: Employee: Genentech, Inc. Stocks: Roche. J. Yi: Consulting agreement: AbbVie, Inc. A. Mecke, A. Falgas: Employee and stock owner: Roche. All other authors have declared no conflicts of interest.

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