PMID- 31060392
OWN - NLM
STAT- MEDLINE
DCOM- 20200617
LR  - 20200617
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 35
IP  - 10
DP  - 2019 Oct
TI  - Treatment patterns, survival and economic outcomes in Medicare-enrolled, older 
      patients with HR+/HER2- metastatic breast cancer.
PG  - 1699-1710
LID - 10.1080/03007995.2019.1615422 [doi]
AB  - Background: Endocrine therapy (ET) remains a foundation of systemic therapy for 
      HR+/ HER2- metastatic breast cancer (MBC), although chemotherapy (CT) is used in 
      select patients. In this "real-world" study, we explored treatment patterns, 
      health care resource use (HCRU), costs, adverse events (AEs) and overall survival 
      (OS) in Medicare-enrolled, older patients with HR+/HER2- MBC. Methods: Patients 
      with HR+/HER2- MBC (2007-2011) and aged >66 years were retrospectively analyzed 
      using the SEER-Medicare data. Treatment patterns, HCRU, costs, AEs and OS after 
      MBC diagnosis through end of study period (31 December 2013) were examined using 
      descriptive and multivariable analyses. Results: Among 3622 eligible patients, ET 
      was the most common treatment (77%), followed by CT (50%), radiation (48%) and 
      surgery (19%). The proportion of patients treated with ET monotherapy decreased 
      across therapy lines, from 74% in first line (1 L) to 35% in 4 L. The total 
      number of unique therapy regimens used was 181 in 1 L, 171 in 2 L, 128 in 3 L, 
      and 95 in 4 L. The median OS from MBC diagnosis was 25.3 months (95% CI, 
      24.0-26.7). In multivariable analyses, receipt of CT and combination CT + ET 
      (versus ET monotherapy) in 1 L, metastatic disease at initial diagnosis, larger 
      tumor size, and presence of visceral and brain metastases at MBC diagnosis 
      significantly predicted receipt of 2 L therapy. Conclusions: ET was the most 
      common first-line treatment for study patients, but its use decreased gradually 
      in the subsequent lines. The heterogeneity in the treatment selection highlights 
      a lack of consensus for the management of HR+/HER2- MBC in routine practice.
FAU - Goyal, Ravi K
AU  - Goyal RK
AUID- ORCID: 0000-0003-1632-036X
AD  - RTI Health Solutions, Research Triangle Park , Durham , NC , USA.
FAU - Carter, Gebra Cuyun
AU  - Carter GC
AD  - Eli Lilly and Company , Indianapolis , IN , USA.
FAU - Nagar, Saurabh P
AU  - Nagar SP
AD  - RTI Health Solutions, Research Triangle Park , Durham , NC , USA.
FAU - Smyth, Emily N
AU  - Smyth EN
AD  - Eli Lilly and Company , Indianapolis , IN , USA.
FAU - Price, Gregory L
AU  - Price GL
AD  - Eli Lilly and Company , Indianapolis , IN , USA.
FAU - Huang, Yu-Jing
AU  - Huang YJ
AD  - Eli Lilly and Company , Indianapolis , IN , USA.
FAU - Li, Li
AU  - Li L
AD  - Eli Lilly and Company , Indianapolis , IN , USA.
FAU - Davis, Keith L
AU  - Davis KL
AD  - RTI Health Solutions, Research Triangle Park , Durham , NC , USA.
FAU - Kaye, James A
AU  - Kaye JA
AD  - RTI Health Solutions , Waltham , MA , USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20190612
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Receptors, Estrogen)
RN  - EC 2.7.10.1 (ERBB2 protein, human)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Breast Neoplasms/chemistry/*drug therapy/mortality/pathology
MH  - Female
MH  - Health Care Costs
MH  - Humans
MH  - *Medicare
MH  - Neoplasm Metastasis
MH  - Receptor, ErbB-2/*analysis
MH  - Receptors, Estrogen/*analysis
MH  - Retrospective Studies
MH  - United States
OTO - NOTNLM
OT  - Metastatic breast cancer
OT  - adverse events
OT  - health care costs
OT  - health care use
OT  - survival
OT  - treatment patterns
EDAT- 2019/05/08 06:00
MHDA- 2020/06/18 06:00
CRDT- 2019/05/08 06:00
PHST- 2019/05/08 06:00 [pubmed]
PHST- 2020/06/18 06:00 [medline]
PHST- 2019/05/08 06:00 [entrez]
AID - 10.1080/03007995.2019.1615422 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2019 Oct;35(10):1699-1710. doi: 10.1080/03007995.2019.1615422. 
      Epub 2019 Jun 12.