Abstract 248P
Background
In August 2017, CDK4/6 inhibitors combined with endocrine therapy have been reimbursed in the Netherlands for patients with hormone receptor positive (HR+), HER2 negative (HER2-) advanced breast cancer (ABC). The aim of this study was to evaluate the implementation of CDK4/6 inhibitors and changes in treatment choices in the Netherlands.
Methods
All patients diagnosed with HR+/HER2- ABC in 2009-2018 in seven hospitals were selected from the Southeast Netherlands Advanced Breast cancer (SONABRE) registry. The two-year cumulative use of CDK4/6 inhibitors since reimbursement date (August 2017) was assessed using competing-risk methodology in two cohorts: patients with ABC diagnosis before and beyond reimbursement. In addition, treatment choices for the first three lines of therapy in 2009-2018 were evaluated.
Results
Among patients diagnosed since August 2017 (n=214), 50% (95%CI:43-57) received CDK4/6 inhibitors within two years beyond diagnosis. In first-line 31% of patients received CDK4/6 inhibitors, against 44% of CDK4/6 inhibitor naïve patients in second-line therapy. Of eligible patients diagnosed before August 2017 (n=417), 31% (95%CI:27-36) received CDK4/6 inhibitors within two years following reimbursement. Another 20% of both cohorts are still CDK4/6 inhibitor naïve and on first-line therapy. The use of chemotherapy decreased in first two lines of therapy between 2009 and 2018 (first-line: 29% to 13%; second-line: 26% to 19%).
Conclusions
The implementation rate of CDK4/6 inhibitors since reimbursement is currently 50% within two years beyond diagnosis and is expected to further increase. The implementation of targeted therapy decreased the use of chemotherapy as first-line therapy.
Clinical trial identification
NCT-03577197.
Editorial acknowledgement
Legal entity responsible for the study
Vivianne C.G. Tjan-Heijnen.
Funding
Netherlands Organization for Health Research and Development (ZonMw: 80-82500-98-8003), Novartis BV, Roche, Pfizer and Eli Lilly.
Disclosure
M. Meegdes: Financial Interests, Institutional, Funding, Grant number 80-82500-98-8003: ZonMw; Financial Interests, Institutional, Funding: Novartis BV; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Eli Lilly. S.M.E. Geurts: Financial Interests, Institutional, Funding, Grant number 80-82500-98-8003: ZonMw; Financial Interests, Institutional, Funding: Novartis BV; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Eli Lilly. N.J.A. Teeuwen: Financial Interests, Institutional, Funding, Grant number 80-82500-98-8003: ZonMw; Financial Interests, Institutional, Funding: Novartis BV; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Eli Lilly. M. De Boer: Financial Interests, Institutional, Funding, Grant number 80-82500-98-8003: ZonMw; Financial Interests, Institutional, Funding: Novartis BV; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Eli Lilly. V.C.G. Tjan-Heijnen: Financial Interests, Institutional, Funding, Grant number 80-82500-98-8003: ZonMw; Financial Interests, Institutional, Funding: Novartis BV; Financial Interests, Institutional, Funding: Roche; Financial Interests, Institutional, Funding: Pfizer; Financial Interests, Institutional, Funding: Eli Lilly. All other authors have declared no conflicts of interest.