OBJECTIVES: in Brazil, data on the treatment patterns of triple negative breast cancer (TNBC) is scarce. The study aimed to describe real world data on treatment patterns of Brazilian TNBC patients in the private healthcare setting.

METHODS: this was an administrative claims database study using secondary data from private insured patients. Patients with 18 years or older, with at least one ICD-10 C50 reported between January 2012 and December 2017 were selected. Further selection followed the exclusion of patients with any claim for hormone or targeted therapy. TNBC patients were classified as early (eTNBC) or metastatic (mTNBC) based on the presence of claims related to metastatic treatment/procedures or ICD-10 codes (C76 to C80).

RESULTS: 3,004 patients were included, we identified 2,488 (82.8%) eTNBC and 516 (17.2%) mTNBC patients. Among eTNBC, 75.3% of the treatment was adjuvant (AT), 17.1% neoadjuvant+adjuvant (NAT/AT) and 7.5% neoadjuvant (NAT). The most common for eTNBC was sequential chemo (57.3% for AT), usually starting with anthracycline + cyclophosphamide, followed by taxane. In eTNBC, 4.4% of the patients presented disease progression during early treatment, receiving mTNBC approach. For the mTNBC, 21.6% were prescribed 1L with bevacizumab and 19.8% with taxane. 48% of 1L switched to 2L, where 34.4% received taxane and 18.4% received gemcitabine-based chemo. Among those treated in 2L, only 12.6% went to a 3L, 21.5% with capecitabine and 15.4% with gemcitabine. The treatment duration in months was 2.91 (SD±4.67) in 1L, 2.91 (SD±2.44) in 2L and 2.65 (SD±2.54) in 3L.

CONCLUSIONS: The treatment of eTNBC was mainly based in AT with anthracycline and taxane, while in mTNBC bevacizumab, capecitabine and gemcitabine were often prescribed. Of interest, the estimated treatment duration observed was shorter in this real-world database than expected in pivotal trials, reflecting the poor prognosis of mTNBC and its unmet medical need.