TARGETED LITERATURE REVIEW OF ADVANCED/METASTATIC TRIPLE-NEGATIVE BREAST CANCER BURDEN OF ILLNESS

Author(s)

Naidoo S1, Friedman ML2, Paly VF2, Hansen R3, Sidhu MK2, Smith I4
1Astellas Pharma Europe, Ltd, Chertsey, UK, 2ICON Health Economics, New York, NY, USA, 3Balanced Outcome Research Associates, LLC, Seattle, WA, USA, 4Astellas Pharma Ltd, Chertsey, UK

OBJECTIVES: To summarize literature on the burden of illness in patients with advanced or metastatic triple-negative breast cancer (TNBC) and identify information that may inform a cost-effectiveness analysis. METHODS: Searches of MEDLINE, Embase, EconLit, and the NHS Economic Evaluation Database were conducted to identify relevant literature describing the epidemiology (January 2006–July 2016), economic burden, quality-of-life (QoL) burden, and treatment guidelines (January 2011–July 2016) associated with TNBC. Search strategies included disease terms for breast cancer, advanced/metastatic disease, and hormone receptor/human epidermal growth factor receptor 2 status. Abstract review, full-text review, and data extraction were conducted by a single reviewer and validated by a second, independent reviewer. RESULTS: A total of 3140 publications were identified; following screening, 36 studies were selected for review (21 epidemiology, two economic, 13 guidelines). Across 11 studies, reported prevalence of the triple-negative (TN) subtype among advanced/metastatic breast cancer ranged from 1.3% to 25.6% (nine out of 14 patient groups had prevalence >15%). Incidence rates were reported to have a similar range (nine studies), and rates of the TN subtype were shown to be higher for younger patients and African-American patients. Among 10 studies reporting overall survival, all but one reported a median of <9 months. Economic evidence was limited (two studies), but indicated increased resource use and higher treatment costs compared with non-TNBC patients. No QoL studies were found for a TNBC population; supplemental searches identified two additional studies in a general metastatic breast cancer population to provide context. Disease progression has the largest impact on QoL in this population; chemotherapy-related adverse events also showed a significant QoL burden. Treatment guidelines generally recommended anthracycline- and taxane-based chemotherapy as initial treatment for TNBC. CONCLUSIONS: This review highlights the paucity of literature available to inform cost-effectiveness evaluations of advanced/metastatic TNBC, indicating a need for further research.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PCN44

Topic

Clinical Outcomes, Epidemiology & Public Health

Topic Subcategory

Relating Intermediate to Long-term Outcomes

Disease

Oncology

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