Real-world treatment in patients with HER2+ metastatic breast cancer : Treatment decisions in HER2+ mBC

Breast Cancer Res Treat. 2018 Feb;168(1):197-205. doi: 10.1007/s10549-017-4567-z. Epub 2017 Nov 23.

Abstract

Purpose: The landscape of HER2+ metastatic breast cancer (mBC) treatment is changing due to the availability of new anti-HER2 drugs. The purpose of this study was to assess the current treatment patterns and sequences used in HER2+ mBC in the real-world setting. Secondary objectives were to describe the factors that influence the decision to prescribe a first and second-line antitumour treatment.

Methods: Retrospective chart review of 3068 cases in Spain, Italy, the Netherlands and the UK.

Results: First and second-line treatments and regimens are consistent with the clinical guidelines, especially for recently initiated treatments. Age and performance status (PS) of patients impact treatment patterns: younger patients received more innovative treatments than elderly patients. In addition, while most patients received a first antitumor treatment, the rate of patients who continue to subsequent lines of therapy is low (55% transitioning from 1st to 2nd line; 58% from 2nd to 3rd line). Age and PS are key factors in the decision to prescribe further antitumor treatment.

Conclusion: Fewer HER2+ mBC patients than expected receive a second and third line therapy. Guidelines should make specific recommendations for older patients or those with a poor PS.

Keywords: Antitumour treatment; HER2+ metastatic breast cancer; Treatment patterns; Treatment rates.

Publication types

  • Multicenter Study

MeSH terms

  • Age Factors
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / standards
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology
  • Clinical Decision-Making
  • Cross-Sectional Studies
  • Disease-Free Survival
  • Female
  • Humans
  • Italy / epidemiology
  • Middle Aged
  • Netherlands / epidemiology
  • Patient Selection*
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Receptor, ErbB-2 / antagonists & inhibitors*
  • Receptor, ErbB-2 / metabolism
  • Retrospective Studies
  • Spain / epidemiology
  • United Kingdom / epidemiology

Substances

  • ERBB2 protein, human
  • Receptor, ErbB-2