Abstract 174P
Background
For patients with early breast cancer (EBC), genomic testing is increasingly informing the likelihood of benefit from adjuvant (adj) chemotherapy (CT). The objective was to examine, by geographic region, genomic/biomarker testing rates and treatment patterns in HR+, HER2- EBC patients in the adj setting.
Methods
Real-world data from France, Germany, Italy, Spain, United Kingdom (EU5), Japan, and United States (US) were drawn from the Adelphi EBC I Disease Specific Programme, a point in time observational study. 320 physicians completed patient record forms (Jul to Oct 2019) for up to the next 8 eligible HR+, HER2- EBC patients receiving or had received adj therapy in the last 12 months, prior to data collection. Data included demographics, genetic/biomarker testing, and treatment received.
Results
N = 2447 patients (98% female, mean age 59.6 yrs, SD 13.0). The frequency of neo-adjuvant (n-adj) therapy varied by region. Adj treatment patterns differed by region and by the use of n-adj therapy. Breast cancer gene (BRCA) testing was more frequent in patients who received n-adj therapy and more common in the US than EU5 and Japan. EU5 had the highest Ki67 testing rates. OncotypeDx was the most frequent multi-gene assay, more so in the US. Mammaprint was less frequent and Adjuvant! Online more frequent in the EU5 than the US and Japan (Table). Table: 174P
| Test* | EU5 n=1859 | US n=347 | Japan n=241 | |||
| N-adj** n=293 (15.8%) | Adj only n=1566 (84.2%) | N-adj** n=92 (26.5%) | Adj only n=255 (73.5%) | N-adj** n=44 (18.3%) | Adj only n=197 (81.7%) | |
| BRCA1 | 100 (34.1%) | 236 (15.1%) | 42 (45.7%) | 96 (37.6%) | 8 (18.2%) | 13 (6.6%) |
| BRCA2 | 91 (31.1%) | 209 (13.3%) | 31 (33.7%) | 87 (34.1%) | 2 (4.5%) | 3 (1.5%) |
| Ki67 | 195 (66.6%) | 1121 (71.6%) | 31 (33.7%) | 73 (28.6%) | 9 (20.5%) | 85 (43.1%) |
| OncotypeDx | 57 (19.5%) | 223 (14.2%) | 31 (33.7%) | 125 (49.0%) | 13 (29.5%) | 30 (15.2%) |
| MammaPrint | 16 (5.5%) | 74 (4.7%) | 10 (10.9%) | 15 (5.9%) | 10 (22.7%) | 9 (4.6%) |
| Adjuvant! Online | 23 (7.8%) | 120 (7.7%) | 2 (2.2%) | 7 (2.7%) | 1 (2.3%) | 26 (13.2%) |
*EndoPredict, Breast Cancer Index, Mammostrat, PAM50 omitted (% use <10%)**Excludes non-Endocrine Therapy
Conclusions
The use of genomic/biomarker testing varied by region. Variation between regions in treatment approach may be driven, in part, by genomic testing/biomarker results as testing is increasingly being used to minimize over and under treatment with CT. Treatment patterns and other factors predicting treatment will be analyzed.
Clinical trial identification
Editorial acknowledgement
Trish Huynh (Eli Lilly and Company, Indianapolis, IN) provided writing assistance.
Legal entity responsible for the study
Eli Lilly and Company.
Funding
Eli Lilly and Company.
Disclosure
M. Method: Shareholder/Stockholder/Stock options, Full/Part-time employment: Eli Lilly and Company. A. Rider: Research grant/Funding (institution): Eli Lilly and Company; Full/Part-time employment: Adelphi Real World. R. Williams: Research grant/Funding (institution): Eli Lilly and Company; Full/Part-time employment: Adelphi Real World. J. Brown: Shareholder/Stockholder/Stock options, Full/Part-time employment: Eli Lilly and Company.