Abstract 196P
Background
Clinical research activity in eTNBC has increased in recent years. Tx patterns, including increased use of NACT, may have changed. Detailed data on current tx patterns in eTNBC may inform future research.
Methods
This retrospective analysis used the nationwide Flatiron Health EHR-derived de-identified database and included adult pts with a diagnosis of non-metastatic invasive breast cancer and ER−/PR−/HER2− test results between 1 Jan 2011 and 1 Mar 2019, with follow-up to Mar 2020. Pts receiving HER2-targeted and hormone tx were excluded. NACT and ACT were defined using dates of surgery and systemic tx initiation. ACT was defined as tx recorded ≤ 12 months after surgery for pts with ≥ 6 months of follow-up from surgery. pCR was defined as either clinician documented pathologic complete response to NACT or pathology report with no evidence of invasive disease. To compare staging, missing clinical stage was completed with pathologic staging for ACT pts.
Results
Of 723 pts with eTNBC who were included, 22.8% (n = 165) 1st received NACT and 34.2% (n = 247) 1st received ACT. 26 (3.5%) pts had no recorded surgery, and 285 (39.4%) had a recorded surgery but no evidence of systemic tx. Among 61 pts treated with systemic tx in 2011/12, NACT was used in 25% (n = 15), increasing to 42% (n = 33) in 2018/19. Pts receiving NACT were younger (median age, 56 vs 60 years) and more commonly presented with higher clinical stage (all P < 0.001). While ACT pts were more likely to have had a unilateral lumpectomy (62% vs 37%), a higher proportion of NACT pts had bilateral mastectomies (13% vs 31%). The most common regimens in the NACT and ACT settings included an anthracycline and a taxane (127 [77.0%] and 126 pts [51.0%], respectively). Among NACT-treated pts, 24 (14.5%) received carboplatin in any combination. Of pts treated with ACT, 1.6% received capecitabine. Of pts treated with NACT, 65 (39%) had a documented pCR.
Conclusions
The majority of pts received ACT as their 1st tx, although the proportion of NACT as 1st tx increased over the study period. Tx patterns followed NCCN guidelines: A combination that included an anthracycline and a taxane was used frequently for NACT and less commonly for ACT.
Clinical trial identification
Editorial acknowledgement
Medical writing assistance for this abstract was provided by Christopher Lum, of Health Interactions, and funded by F. Hoffmann-La Roche, Ltd.
Legal entity responsible for the study
F. Hoffmann-La Roche, Ltd.
Funding
F. Hoffmann-La Roche, Ltd.
Disclosure
L.A. Emens: Full/Part-time employment, current: University of Pittsburgh/UPMC; Full/Part-time employment, 2001-2008: Johns Hopkins University; Full/Part-time employment, 2012-2016: FDA-CTGTAC; Officer/Board of Directors, non-profit: SITC; Honoraria (self), Advisory/Consultancy, Leadership role, Research grant/Funding (institution), Travel/Accommodation/Expenses, Co-chair IMpassion130 Steering Committee, Chair KATE2 Steering Committee: Roche/GNE; Honoraria (self), Advisory/Consultancy, Leadership role, Chair TRIO-025 DSMB: Trio/Syndax; Leadership role, Steering committee member: Ambiance Trial; Honoraria (self), Advisory/Consultancy: AbbVie; Honoraria (self), Advisory/Consultancy: Amgen; Honoraria (self), Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: AstraZeneca; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Bayer; Advisory/Consultancy, Research grant/Funding (institution), Travel/Accommodation/Expenses: Bristol-Meyers Squibb; Honoraria (self), Advisory/Consultancy: Celgene; Honoraria (self), Advisory/Consultancy, no compensation: eTHeRNA; Honoraria (self), Advisory/Consultancy: Gritstone; Honoraria (self), Advisory/Consultancy: Medimmune; Shareholder/Stockholder/Stock options, Potential for stock in future: Molecuvax; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Macrogenics; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Novartis; Honoraria (self), Advisory/Consultancy: Peregrine; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Replimmune; Honoraria (self), Advisory/Consultancy, Travel/Accommodation/Expenses: Vaccinex; Research grant/Funding (institution): Aduro Biotech; Research grant/Funding (institution): Breast Cancer Research Foundation; Research grant/Funding (institution): Corvus; Research grant/Funding (institution): Department of Defense; Research grant/Funding (institution): EMD Serono; Research grant/Funding (institution): HeritX, Inc.; Research grant/Funding (institution): Maxcyte; Research grant/Funding (institution), (separate relationships, ran out of lines): Merck, National Cancer Institute, NSABP Foundation, Translational Breast Cancer Research Consortium . C. Craggs: Full/Part-time employment: Roche/GNE. M. Debiasi: Full/Part-time employment: Roche. C. Flores-Avile: Full/Part-time employment: Roche/GNE. D. Incerti: Full/Part-time employment: Roche/GNE. M.K. Downer: Shareholder/Stockholder/Stock options, Full/Part-time employment: Roche/GNE. P. Dhillon: Shareholder/Stockholder/Stock options, Full/Part-time employment: Roche/GNE. E. Mittendorf: Advisory/Consultancy: Merck; Advisory/Consultancy: Genomic Health; Advisory/Consultancy: Sellas Lifesciences; Research grant/Funding (institution): GlaxoSmithKline.