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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

4625 - Clinical Outcomes, Treatment Patterns and Health Resource Utilization (HRU) Among Metastatic Breast Cancer (mBC) Patients (pts) with Germline BRCA Mutation (gBRCAm)

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

Topics

Bioethical Principles and GCP;  Targeted Therapy;  Genetic and Genomic Testing, Counseling;  Breast Cancer

Presenters

Ruben Quek

Citation

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

Authors

R. Quek, J. Mardekian

Author affiliations

  • Health Economics, Pfizer, Inc., 94080 - San Francisco/US
More

Resources

Abstract 4625

Background

With evolving gBRCAm BC guideline landscape, we present latest gBRCA testing rates among mBC US pts with HR+/HER2- or triple negative BC (TNBC); including clinical outcomes, treatment patterns and HRU in gBRCAm pts.

Methods

The Flatiron Health database was used in a real world retrospective analysis of mBC pts with HR+/HER2- or TNBC, ≥18 yrs old, diagnosed between Jan 2011-Feb 2018. Rates of gBRCA testing were assessed. One- to 5-yr overall survival (OS) post mBC diagnosis for gBRCAm HR+/HER2- and TNBC pts were estimated. Cox proportional hazards model was used to estimate OS of TNBC vs HR+/HER2-. Outcomes between TNBC vs HR+/HER2- pts were compared while adjusting for imbalances. Antineoplastic treatment was summarized and HRU patterns were analyzed using t-tests.

Results

The study included 12,021 mBC pts (10,291 HR+/HER2-; 1730 TNBC). Results for gBRCA testing were available for 16.7% of pts overall; (HR+/HER2-: 15.4%, TNBC: 24.2%). The most common 1st line treatments for gBRCAm TNBC were capecitabine (19%) and carboplatin/gemcitabine (15%) and 1st line treatments for gBRCAm HR+/HER2- included letrozole (10%) and fulvestrant (7%). Pts counts, OS estimates and HRU for gBRCAm carriers are shown in the table; Cox regression results showed lower OS for gBRCAm TNBC pts vs gBRCAm HR+/HER2- mBC pts, Hazard Ratio (HR+/HER2- / TNBC) and 95% CI 0.59 (0.34, 1.01). Estimated median OS and 5-yr OS rates are (33.9 mths, 22.3 mths) and (28.9%, 26.4%) for gBRCAm HR+/HER2- and TNBC pts respectively. Number of HRU visits per-pts-per-year were significantly higher among TNBC pts.

Conclusions

gBRCA testing rates among mBC pts with HR+/HER2- or TNBC were low. Among mBC pts with gBRCAm, 5-yr OS rates were < 29% for both HR+/HER2- and TNBC; poor prognosis and HRU burden demonstrates a significant unmet need for more targeted, less HRU-intensive treatment options among these pts.Table: 310P

HR+/HER2-TNBC
Total Patients (N = 12,021) n (%)10,291 (85.6)1730 (14.4)
Patients with gBRCA test results (n = 2005) n (%)1587 (79.2)418 (20.8)
Patients with gBRCAm (n = 229) n (%)165 (72.1)64 (27.9)
gBRCAm patients with ≥ 1st Line antineoplastic treatment (n = 188) n (%)142 (75.5)46 (24.5)
YearOverall Survival Estimates (%)
193.469.5
258.646.3
345.826.4
430.726.4
528.926.4
Number of Health Resource Utilization Visits (per patient per year) mean (std dev) *p < 0.05
Treatment Visits*17.4 (14.4)40.8 (21.8)
Lab Visits*24.2 (10.1)40.3 (44.2)
Vital Visits*27.4 (14.3)49.9 (66.8)
ALL*35.2 (30.3)65.0 (84.7)

Clinical trial identification

Legal entity responsible for the study

Pfizer, Inc.

Funding

Pfizer, Inc.

Editorial Acknowledgement

Disclosure

R. Quek, J. Mardekian: Employee: Pfizer Inc.

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