Peter A Kaufman1, Sara A Hurvitz2, Joyce O'Shaughnessy3, Ginny Mason4, Denise A Yardley5, Adam M Brufsky6, Hope S Rugo7, Melody Cobleigh8, Sandra M Swain9, Debu Tripathy10, Anne Morris11, Vincent Antao11, Haocheng Li12, Mohammad Jahanzeb13. 1. Breast Oncology, Division of Hematology/Oncology, University of Vermont Cancer Center, University of Vermont Medical Center, 89 Beaumont Avenue, Burlington, VT, 05405, USA. peter.kaufman@uvmhealth.org. 2. David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. 3. Department of Medical Oncology, Baylor University Medical Center, Texas Oncology and US Oncology, Dallas, TX, USA. 4. Inflammatory Breast Cancer Research Foundation, West Lafayette, IN, USA. 5. Breast Cancer Research Program, Sarah Cannon Research Institute and Tennessee Oncology, PLLC, Nashville, TN, USA. 6. Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 7. Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA. 8. Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA. 9. Georgetown Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. 10. MD Anderson Cancer Center, The University of Texas, Houston, TX, USA. 11. Genentech, Inc., South San Francisco, CA, USA. 12. F. Hoffmann-La Roche, Mississauga, ON, Canada. 13. Florida Precision Oncology, a Division of 21st Century Oncology, Boca Raton, FL, USA.
Abstract
BACKGROUND: Systemic Therapies for HER2-Positive Metastatic Breast Cancer Study (SystHERs, NCT01615068) was a prospective, observational disease registry designed to identify treatment patterns and clinical outcomes in patients with HER2-positive metastatic breast cancer (MBC) in real-world treatment settings. METHODS: SystHERs enrolled patients aged ≥ 18 years with recently diagnosed HER2-positive MBC. Treatment regimens and clinical management were determined by the treating physician. In this analysis, patients were compared descriptively by first-line treatment, age, or race. Multivariate logistic regression was used to examine the associations between baseline variables and treatment selections. Clinical outcomes were assessed in patients treated with trastuzumab (Herceptin [H]) + pertuzumab (Perjeta [P]). RESULTS: Patients were enrolled from June 2012 to June 2016. As of February 22, 2018, 948 patients from 135 US treatment sites had received first-line treatment, including HP (n = 711), H without P (n = 175), or no H (n = 62) (with or without chemotherapy and/or hormonal therapy). Overall, 68.7% received HP + taxane and 9.3% received H without P + taxane. Patients aged < 50 years received HP (versus H without P) more commonly than those ≥ 70 years (odds ratio 4.20; 95% CI, 1.62-10.89). Chemotherapy was less common in patients ≥ 70 years (68.2%) versus those < 50 years (88.0%) or 50-69 years (87.4%). Patients treated with HP had median overall survival of 53.8 months and median progression-free survival of 15.8 months. CONCLUSIONS: Our analysis of real-world data shows that most patients with HER2-positive MBC received first-line treatment with HP + taxane. However, older patients were less likely to receive dual HER2-targeted therapy and chemotherapy.
BACKGROUND: Systemic Therapies for HER2-Positive Metastatic Breast Cancer Study (SystHERs, NCT01615068) was a prospective, observational disease registry designed to identify treatment patterns and clinical outcomes in patients with HER2-positive metastatic breast cancer (MBC) in real-world treatment settings. METHODS: SystHERs enrolled patients aged ≥ 18 years with recently diagnosed HER2-positive MBC. Treatment regimens and clinical management were determined by the treating physician. In this analysis, patients were compared descriptively by first-line treatment, age, or race. Multivariate logistic regression was used to examine the associations between baseline variables and treatment selections. Clinical outcomes were assessed in patients treated with trastuzumab (Herceptin [H]) + pertuzumab (Perjeta [P]). RESULTS: Patients were enrolled from June 2012 to June 2016. As of February 22, 2018, 948 patients from 135 US treatment sites had received first-line treatment, including HP (n = 711), H without P (n = 175), or no H (n = 62) (with or without chemotherapy and/or hormonal therapy). Overall, 68.7% received HP + taxane and 9.3% received H without P + taxane. Patients aged < 50 years received HP (versus H without P) more commonly than those ≥ 70 years (odds ratio 4.20; 95% CI, 1.62-10.89). Chemotherapy was less common in patients ≥ 70 years (68.2%) versus those < 50 years (88.0%) or 50-69 years (87.4%). Patients treated with HP had median overall survival of 53.8 months and median progression-free survival of 15.8 months. CONCLUSIONS: Our analysis of real-world data shows that most patients with HER2-positive MBC received first-line treatment with HP + taxane. However, older patients were less likely to receive dual HER2-targeted therapy and chemotherapy.