Health Status/Utilities in Adult Patients with Germline BRCA1/2 Mutated (GBRCA1/2MUT) HER2- Advanced Breast Cancer (ABC) Treated with POLY(ADP-RIBOSE) Polymerase Inhibitors (PARPI) Versus Chemotherapy in a Real World (RW) Setting
Author(s)
Mahtani R1, Niyazov A2, Lewis K3, Pike J3, Rider A3, Arondekar B4, Lux MP5
1Sylvester Cancer Center, University of Miami, Deerfield Beach, FL, USA, 2Pfizer Inc., New York, NY, USA, 3Adelphi Real World, Bollington, UK, 4Pfizer Inc., Collegeville, PA, USA, 5Kooperatives Brustzentrum Paderborn, Frauenklinik St. Louise, Paderborn, St. Josefs-Krankenhaus, Salzkotten, Frauen- und Kinderklinik St. Louise, Paderborn, Germany
OBJECTIVES: Evidence from randomized clinical trials in patients with gBRCA1/2mut HER2- locally advanced and/or metastatic breast cancer treated with PARPi vs. chemotherapy demonstrated significant improvements in clinical and patient reported outcomes (PROs). As PARPi are recently approved in multiple countries, limited information is available on the impact of PARPi on PROs in the RW. We assessed health status/utilities among adult patients with gBRCA1/2mut HER2- ABC in Germany, France, Italy, Spain (EU4), US and Israel. METHODS: Oncologists were recruited to abstract data from medical records (2019/2020) for patients with gBRCA1/2mut HER2- ABC treated with chemotherapy or PARPi monotherapy. A subset of patients completed the EuroQol-5 Dimension 5 level (EQ-5D-5L) which was scored (Van Hout crosswalk method), based on individual 3L country tariffs. Scores were compared utilizing inverse probability weighted regression adjustment controlling for multiple confounding factors. A higher EQ-5D Index represents better health status. EQ-5D dimensions were compared as numeric variables scored 1-5 (1 = no problem, 5 = extreme problem). RESULTS: Overall 96 patients participated; mean age was 51 years. Tumor characteristics were: 34.4% hormone receptor (HR+)/HER2-, 65.6% triple negative breast cancer. Chemotherapy (n=58) was received among 60.4% of patients [n=29 (50.0%) platinum based, n=29 (50.0%) non-platinum based], and PARPi was received among 39.6% of patients (n=38). Patients receiving PARPi reported better mean scores across all dimensions of the EQ-5D vs. chemotherapy: mobility (1.38 vs 1.68, p=0.077), self-care (1.32 vs. 1.50, p=0.161), usual activities (1.56 vs. 1.94, p=0.043), pain/discomfort (1.72 vs. 1.99, p=0.176), and anxiety/depression (2.15 vs. 2.40, p=0.316). Health status was significantly higher among patients receiving PARPi vs. chemotherapy (0.83 vs. 0.75, p=0.044). CONCLUSIONS: Patients receiving PARPi were less likely to experience disruption to their usual activities and reported better overall health utility/status vs. chemotherapy in this RW study. Additional studies to validate these findings are planned. Funding: Pfizer
Conference/Value in Health Info
2020-11, ISPOR Europe 2020, Milan, Italy
Value in Health, Volume 23, Issue S2 (December 2020)
Code
PCN323
Topic
Clinical Outcomes, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Clinical Outcomes Assessment, Disease Management, Health State Utilities, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Drugs, Oncology