U.S. prevalence of endocrine therapy-naïve locally advanced or metastatic breast cancer.


Journal

Current oncology (Toronto, Ont.)
ISSN: 1718-7729
Titre abrégé: Curr Oncol
Pays: Switzerland
ID NLM: 9502503

Informations de publication

Date de publication:
04 2019
Historique:
entrez: 3 5 2019
pubmed: 3 5 2019
medline: 1 4 2020
Statut: ppublish

Résumé

Variations in treatment choice, or late stage at first diagnosis, mean that, despite guideline recommendations, not all patients with hormone receptor (hr)-positive locally advanced or metastatic breast cancer (la/mbca) will have received endocrine therapy before disease progression. In the present study, we aimed to estimate the proportion of women with postmenopausal hr-positive la/mbca in the United States who are endocrine therapy-naïve. Women in the Optum Electronic Health Record (ehr) database with a breast cancer (bca) diagnosis (January 2008-March 2015) were included. Patient and malignancy characteristics were identified using structured data fields and natural-language processing of free-text clinical notes. The proportion of women with postmenopausal hr-positive, human epidermal growth factor 2 (her2)-negative (or unknown) la/mbca who had not received prior endocrine therapy was determined. Results were extrapolated to the entire U.S. population using the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results database. Results are presented descriptively. In the ehr database, 11,831 women with bca had discernible information on postmenopausal status, hr status, and disease stage. Of those women, 1923 (16.3%) had postmenopausal hr-positive, her2-negative (or unknown) la/mbca, and 70.7% of those 1923 patients ( A substantial proportion of women with postmenopausal hr-positive la/mbca in the United States could be endocrine therapy-naïve.

Sections du résumé

Background
Variations in treatment choice, or late stage at first diagnosis, mean that, despite guideline recommendations, not all patients with hormone receptor (hr)-positive locally advanced or metastatic breast cancer (la/mbca) will have received endocrine therapy before disease progression. In the present study, we aimed to estimate the proportion of women with postmenopausal hr-positive la/mbca in the United States who are endocrine therapy-naïve.
Methods
Women in the Optum Electronic Health Record (ehr) database with a breast cancer (bca) diagnosis (January 2008-March 2015) were included. Patient and malignancy characteristics were identified using structured data fields and natural-language processing of free-text clinical notes. The proportion of women with postmenopausal hr-positive, human epidermal growth factor 2 (her2)-negative (or unknown) la/mbca who had not received prior endocrine therapy was determined. Results were extrapolated to the entire U.S. population using the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results database. Results are presented descriptively.
Results
In the ehr database, 11,831 women with bca had discernible information on postmenopausal status, hr status, and disease stage. Of those women, 1923 (16.3%) had postmenopausal hr-positive, her2-negative (or unknown) la/mbca, and 70.7% of those 1923 patients (
Conclusions
A substantial proportion of women with postmenopausal hr-positive la/mbca in the United States could be endocrine therapy-naïve.

Identifiants

pubmed: 31043825
doi: 10.3747/co.26.4163
pii: conc-26-e180
pmc: PMC6476436
doi:

Substances chimiques

Antineoplastic Agents, Hormonal 0
Receptors, Estrogen 0
Receptors, Progesterone 0
Receptors, Steroid 0
ERBB2 protein, human EC 2.7.10.1
Receptor, ErbB-2 EC 2.7.10.1

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e180-e187

Déclaration de conflit d'intérêts

CONFLICT OF INTEREST DISCLOSURES We have read and understood Current Oncology’s policy on disclosing conflicts of interest, and we declare the following interests: TD, JL, and NJ are employees of, and receive a salary from, AstraZeneca; APN, CL, EG, MD, and JDS are employees of Optum Epidemiology, which conducted this research under a contract with AstraZeneca; APN and JDS also own stock in United Health Group; TD owns stock in Achillion Pharmaceuticals, AstraZeneca, Bristol–Myers Squibb, Gilead, Inovio Pharmaceuticals, and Roche. WJG has no conflicts to disclose.

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Auteurs

A P Nunes (AP)

Optum Epidemiology, Boston, MA, U.S.A.
Division of Epidemiology, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, U.S.A.

C Liang (C)

Optum Epidemiology, Boston, MA, U.S.A.

W J Gradishar (WJ)

Feinberg School of Medicine, Northwestern University, Chicago, IL, U.S.A.

T Dalvi (T)

AstraZeneca, Gaithersburg, MD, U.S.A.

J Lewis (J)

AstraZeneca, Cambridge, U.K.

N Jones (N)

AstraZeneca, Cambridge, U.K.

E Green (E)

Optum Epidemiology, Boston, MA, U.S.A.

M Doherty (M)

Optum Epidemiology, Boston, MA, U.S.A.

J D Seeger (JD)

Optum Epidemiology, Boston, MA, U.S.A.

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Classifications MeSH