Abstract 1437
Background
A task force was created by the Belgian Society of Medical Oncology (BSMO) to monitor the quality of treatment of breast cancer in Belgium. In collaboration with the Belgian Cancer Registry an analysis of the data was performed in search of reliable quality indicators. Finding actionable differences can lead to better treatment of our patients.
Methods
Data of 48,872 patients diagnosed with invasive breast cancer between 2010 and 2014 were analysed. To enable risk stratification according to their surrogate subtype, pathology reports of year 2014 were manually checked (9,855 patients). We identified patients < 70 Y (years) and > 75 Y receiving adjuvant radiotherapy after mastectomy and the different systemic treatments in each surrogate subtype. We also calculated the total length of endocrine treatment and the percentage of chemotherapy given in first line ER+ metastatic patients.
Results
In cStage I-III, post-mastectomy radiotherapy was administered in 70.7% of the patients <70 Y and in 46.5% of patients > 75 Y, with an important intercenter variability. 81.7% of the cStage I-III patients <70 Y received at least 4.5 years of adjuvant endocrine therapy, with a slight decrease each year. In the 2014 cohort we identified 54.4% luminal A-like, 14.9% luminal B-like HER2-, 12.4% luminal B-like HER2+, 4.6% non luminal HER2+, 8.6% triple negative and 5.1% unknown. As a negative indicator, 44.6% of the HER2+ pT1aN0 patients <70 Y received adjuvant trastuzumab, compared to 22.2% of the patients > 70 Y. As first treatment for cStage IV HR+/HER2- patients, we identified endocrine therapy in 53.9% and chemotherapy in 17.3%.
Conclusions
Substantial treatment differences were observed among centers. Overtreatment is an important negative quality aspect of breast cancer management. A frequent use of postmastectomy radiotherapy was observed. The use of trastuzumab was inappropriate in pT1aN0 patients. Chemotherapy was used too often in first line hormone receptor positive metastatic patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Belgian Cancer Registry.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
1694 - Pembrolizumab (pembro) Plus mFOLFOX or FOLFIRI in Patients With Metastatic Colorectal Cancer (mCRC): KEYNOTE-651 Cohorts B and D
Presenter: Richard Kim
Session: Poster Display session 2
Resources:
Abstract
908 - Romidepsin (FK228) Regulates the Expression of the Immune Checkpoint Ligand PD-L1 and Exerts Synergistic Anti-Tumor Activity with an Anti-PD-1 Antibody in Colon Cancer
Presenter: Hui Li
Session: Poster Display session 2
Resources:
Abstract
3127 - Prognostic significance of circulating regulatory T lymphocytes (Tregs) in patients with metastatic colorectal cancer (mCRC) under treatment with first line chemotherapy.
Presenter: Zafeiris Zafeiriou
Session: Poster Display session 2
Resources:
Abstract
5416 - The SAFFO study: Sex-related prognostic role And cut-oFf deFinition of monocyte-to-lymphocyte ratio (MLR) in metastatic colOrectal cancer
Presenter: Camilla Lisanti
Session: Poster Display session 2
Resources:
Abstract
2518 - SPICE, a phase I study of enadenotucirev in combination with nivolumab in tumors of epithelial origin: analysis of the metastatic colorectal cancer patients in the dose escalation phase
Presenter: Marwan Fakih
Session: Poster Display session 2
Resources:
Abstract
4000 - Phase 1/2 study with CXCL12 inhibitor NOX-A12 and pembrolizumab in patients with microsatellite-stable, metastatic colorectal or pancreatic cancer
Presenter: Niels Halama
Session: Poster Display session 2
Resources:
Abstract
2223 - Microsatellite Instability Status in Metastatic Colorectal Cancer and Effect of Immune Checkpoint Inhibitors on Survival in MSI-High Metastatic Colorectal Cancer
Presenter: Wataru Okamoto
Session: Poster Display session 2
Resources:
Abstract
2569 - Phase II trial of Trametinib (T) and Panitumumab (Pmab) in RAS/RAF wild type (wt) metastatic colorectal cancer (mCRC)
Presenter: Kanan Alshammari
Session: Poster Display session 2
Resources:
Abstract
5402 - Microsatellite instability and immunogenicity in colorectal cancer – do resident memory Tcells (Trm) play a role in colorectal cancer
Presenter: Wei Toh
Session: Poster Display session 2
Resources:
Abstract
5472 - Early response evaluation and CEA response in patients treated in a Danish randomized study comparing trifluridine/tipiracil (TAS-102) with or without bevazicumab in patients with chemorefractory metastatic colorectal cancer (mCRC)
Presenter: Camilla Qvortrup
Session: Poster Display session 2
Resources:
Abstract