Abstract 249P
Background
CDK4/6 inhibitors (CDKIs) are indicated in the treatment of HR+/HER2- locally advanced to metastatic breast cancer. This study aims at understanding the evolution of the use of CDKIs (Palbociclib, Ribociclib & Abemaciclib) in the EU5 from 2017 to 2020.
Methods
This study was conducted using Oncology Dynamics™, an IQVIA cross-sectional survey collecting anonymized real-world patient data. 21,000 cases of drug treated HR+/HER2- breast cancer patients, in locally advanced to metastatic stages, excluding clinical trials, were collected across France, Germany, Italy, Spain & the UK. 8,019 patients were studied for side effects analysis.
Results
In locally advanced to metastatic HR+/HER2- breast cancer patients, the use of CDKIs increased from 7.5% in 2017 to 41.9% in 2020. This rise is observed as we see a decline in other approaches, namely Aromatase Inhibitors (AIs) monotherapy or standard chemotherapy. (Table) Moreover, the use of CDKIs is becoming more frequent in 1st line (58.6% in 2017 – 87.0% in 2020). CDKIs can be used in combination with AIs or fulvestrant. The combination with AIs is increasing (50.6% in 2017 - 71.7% in 2020) as the use with fulvestrant is declining (43.6% in 2017 - 26.6% in 2020). (Table) The use of AIs in combination with CDKIs has led to an overall increase in AIs use in this population, as 40.3% of patients’ regimens included an AI in 2017 and 52.6% in 2020. Neutropenia is the most common side effect observed in CDKI treated patients. In our sample (2017 - 2020) 44.1% of CDKI treated patients presented neutropenia and only 11.9% in the non-CDKI treated patients. Table: 249P
| 2017 | 2018 | 2019 | 2020 | ||
| Total HR+/HER2- locally advanced to metastatic patients (pts) | 4,368 pts | 5,084 pts | 5,689 pts | 5,859 pts | |
| CDKI treated & combinations | CDKI pts (% of total) | 326 pts (7.5%) | 1,281 pts (25.2%) | 2,140 pts (37.6%) | 2,455 pts (41.9%) |
| CDKI + Fulvestrant | 142 pts (43.6%) | 338 pts (26.4%) | 581 pts (27.1%) | 653 pts (26.6%) | |
| CDKI + AI | 165 pts (50.6%) | 903 pts (70.5%) | 1,483 pts (69.3%) | 1,760 pts (71.7%) | |
| CDKI +/- Others | 19 pts (5.8%) | 40 pts (3.1%) | 76 pts (3.6%) | 42 pts (1.7%) | |
| AI monotherapy | pts (% of total) | 1,267 pts (29.0%) | 1,183 pts (23.3%) | 1,197 pts (21.0%) | 1,140 pts (19.5%) |
| All other regimens (non-CDKI / non-AI monotherapy) | pts (% of total) | 2,775 pts (63.5%) | 2,620 pts (51.5%) | 2,352 pts (41.3%) | 2,264 pts (38.6%) |
Conclusions
Between 2017 and 2020, CDKIs have become a treatment of choice in HR+/HER2- locally advanced to metastatic breast cancer. Their use in combination with AIs has induced an increase in overall AIs use for this population. The use of CDKIs is becoming more common in 1st line. Neutropenia is the most common side effect for CDKIs affecting 44.1% of the treated population.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
IQVIA.
Funding
IQVIA LTD.
Disclosure
All authors have declared no conflicts of interest.