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Old 05-18-2014, 01:56 PM   #1
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Post Comorbidity, metastases, and survival in women with metastatic breast cancer (mBC) re

Comorbidity, metastases, and survival in women with metastatic breast cancer (mBC) receiving HER2-targeted agents (H2Ts).

Abstract No:
Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2014 ASCO Annual Meeting but not presented at the Meeting, can be found online only.

Author(s): Nicole Meyer, Yanni Hao, Xue Song, William M. Johnson, Nianwen Shi, Jaqueline Willemann Rogerio, Denise A. Yardley; Truven Health Analytics, Inc., Cambridge, MA; Novartis Pharmaceuticals Corporation, East Hanover, NJ; Sarah Cannon Research Institute/Tennessee Oncology, PLLC, Nashville, TN
Abstract Disclosures


Background: Little information on survival is available for subgroups of HER2+ mBC patients. Study objectives were to compare clinical histories, progression, and survival of mBC patients treated with H2Ts, by de novo vs recurrent status , ER+ status, and age. Methods: Women ≥ 18 years with Stage IV mBC (index) during 2008-2012 and treated with H2Ts were selected from a large claims database and followed until death or end of data. Patients were stratified by ER+ status, de novo (≤90 days between initial BC diagnosis and index) vs recurrent (>90 days between initial BC diagnosis and index), and ages 18-44, 45-64, or 65+. Relative risk of progression and death were evaluated among the subset of patients with mortality data. Results: Of 2,629 eligible patients, 52% were ER+, 37% de novo, 15% 18-44, 69% 45-64 and 16% 65+. Median follow-up was longer for ER+ vs ER-, de novo vs recurrent, and decreased with age. Baseline comorbid conditions were lower for ER+ vs ER-, higher for de novo vs recurrent and increased with age. ER+ patient had fewer index metastases, were less likely to have liver, lung and brain but more likely to have bone metastases vs ER-. De novo had more index metastases sites, but lower rates of brain and lung metastases vs recurrent. Among the 32% of patient with mortality information, progression was similar by ER+ status, lower in de novo vs recurrent, and lowest for ages 45-64, while mortality rates were higher for ER- vs ER+ (33% vs 19%), recurrent vs de novo (29% vs 18%) and increased with age (18% 18-44, 23% 45-64, 40% 65+). Multivariate analysis suggested the risk of progression was 30% lower among ER+ patients vs ER- , 32% lower for de novo vs recurrent, and similar across age groups. The risk of death was 52% lower for ER+ vs ER-, 35% lower for de novo vs recurrent, and increased with age. Conclusions: Among mBC patients treated with H2Ts, ER+ status and younger age were associated with lower comorbidity, fewer sites of metastases at index and decreased risk of death during follow-up. De novo patients presented with more comorbid conditions and sites of metastases at index, but had lower risk of progression or death during follow-up vs. recurrent patients.
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