REAL-WORLD TREATMENT PATTERNS OF EVEROLIMUS + EXEMESTANE IN PATIENTS WITH HORMONE-RECEPTOR-POSITIVE, HUMAN EPIDERMAL GROWTH FACTOR RECEPTOR-NEGATIVE ADVANCED BREAST CANCER BY LINE OF THERAPY- A GLOBAL CHART REVIEW

Author(s)

Costanzo V¹, Zarbá J², Michelotti A³, Livi L⁴, Villanueva C⁵, Bordonaro R⁶, Sherstnev V⁷, Kowalyszyn R⁸, Marinsek N⁹, Zhou Z¹⁰, Macalalad AR¹⁰, Koo V¹⁰, Trieschman E¹⁰, Xie J¹¹, Signorovitch J¹², Petracci F¹, Korbenfeld E¹³, Ratto B¹⁴, Higuchi K¹⁴, Saghatchian M¹⁵
¹Instituto Fleming, CABA, Argentina, ²Centro Médico San Roque, TUCUMÁN, Argentina, ³Azienda Ospedaliero Universitaria Pisana, Pisa, Italy, ⁴Azienda Ospedaliero Universitaria Careggi, Florence, Italy, ⁵CHRU de Besançon, Besançon, France, ⁶ARNAS Garibaldi Nesima, Catania, Italy, ⁷Oncology Clinical Oncology Dispensary #5, Moscow, Russian Federation, ⁸Clinica Viedma, Viedma Rio Black, Argentina, ⁹Navigant Consulting, London, UK, ¹⁰Analysis Group, Inc., Boston, MA, USA, ¹¹Analysis Group, Inc., New York, NY, USA, ¹²Analysis Group, Boston, MA, USA, ¹³Hospital Británico de Buenos Aires, Buenos Aires, Argentina, ¹⁴Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, ¹⁵Institut Gustave Roussy, Villejuif, France

OBJECTIVES: EVE+EXE is efficacious in postmenopausal women with HR+/HER2− aBC after failure of a nonsteroidal aromatase inhibitor (NSAI). We aimed to describe real-world treatment patterns of EVE-based therapy in this population. METHODS: This retrospective chart review included postmenopausal patients with HR+/HER2− aBC previously treated with an NSAI who later received EVE+ET, ET alone, or chemotherapy (the index treatment) from 17 sites in 6 countries (Canada, the Netherlands, France, Italy, Russia, or Argentina). This planned subset analysis describes treatment patterns, with additional stratification by dosing (<10 mg/day [low dose] vs 10mg/day [regular dose]) for all patients receiving EVE as the index treatment. Time on treatment (TOT) was estimated with Kaplan-Meier analysis. RESULTS: Index treatment in the EVE+ET group (n=119) was first- or second-line in 77 patients (65%) and third- or fourth-line in 42 patients (35%); 98% of patients received EVE+EXE. Physicians most frequently cited treatment efficacy as the primary reason for prescribing EVE (75%). The initial EVE dose was low for 13 patients (11%; all 5 mg/day), regular for 103 patients (87%), and unknown for the remaining patients. Dose interruption (31% vs 29%) and median TOT (7.7 vs 9.1 months) were similar for low-dose vs regular-dose EVE. Overall, 48 patients (40%) had dose reductions/interruptions due to adverse events (AEs), but only 15 (13%) discontinued EVE due to AEs. The most common AEs leading to dose reduction/interruption in the low-dose and regular-dose groups were pneumonitis (50%) and stomatitis (43%), respectively. AE-related discontinuations occurred in 13% of all patients. 68/85 patients with prior aBC treatment received ET. 50/72 patients with subsequent treatment received chemotherapy. CONCLUSIONS: Most patients received regular-dose EVE, as labeled. Low-dose vs regular-dose EVE had similar treatment patterns; tolerability-related discontinuation was not prevalent. EVE+ET could be an option for patients seeking a more efficacious treatment with manageable tolerability.

Conference/Value in Health Info

2016-05, ISPOR 2016, Washington DC, USA

Value in Health, Vol. 19, No. 3 (May 2016)

Code

PCN17

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Oncology

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