OBJECTIVES : To summarize available data related to the humanistic and economic burden of Triple-Negative Breast Cancer (TNBC).

METHODS : Literature searches were conducted on main databases (MEDLINE®, Embase, EconLit, CENTRAL, NHSEED) from inception to May 2018 and on conference proceedings (ASCO, ESMO and SABC) covering the period between 2016 to the end of 2018. The search results were screened for outcomes of interest, including patient-reported outcomes, health-related quality of life, health resource utilization, cost, burden of illness, incremental cost-effectiveness, and cost-utility.

RESULTS : We identified 34 and 6 eligible publications for humanistic and economic burden, respectively. Humanistic burden was negatively impacted by the toxicity of systemic chemotherapy, the current standard of care for TNBC. Increased risk of metastatic recurrence, often in brain, was associated with cognitive impairment and recurrent pain. Two prospective studies demonstrated that the burden can be alleviated by appropriate bio-psychological interventions and by nursing staff helping patients with coping strategies.

Regarding economic burden, all-cause cost, including medication costs, for stage IV TNBC ranged from $5,773 to $11,028 (USD 2013) per month based on US administrative database studies. In a US clinical registry study, compared to HR+/HER2-negative patients, resource use for healthcare visits was higher for TNBC patients while survival outcomes were poorer. Also, bevacizumab + paclitaxel versus paclitaxel alone had a greater incremental cost-effectiveness ratio for the TNBC group relative to the overall HER2-negative metastatic breast cancer population in the US. In the UK, the use of eribulin versus a pooled comparator of capecitabine or chemotherapy/radiotherapy was considered cost-effective for advanced TNBC patients.

CONCLUSIONS : In TNBC, there is a scarcity of data on humanistic and especially on economic burden. TNBC was associated with high resource utilization and associated costs for health systems. This review highlights the need for continuing research on humanistic and economic burdens of TNBC.