Novick Diego, Lee Sae Young, Koo Dong Hyun, Szende Agota, Colman Sam
GPORWE International, Eli Lilly and Company, Windlesham, Surrey, UK.
Medical Department, Eli Lilly and Company Korea, Seoul, Korea.
J Drug Assess. 2022 Aug 8;11(1):12-19. doi: 10.1080/21556660.2022.2107834. eCollection 2022.
To understand current treatment patterns and health care resource utilization (HRU) of women with locally advanced or metastatic breast cancer (advanced breast cancer; ABC) in Korea overall and within patients who had progressed with prior endocrine therapy (as first-line treatment for metastatic disease) and patients with no prior systemic treatment (for advanced disease).
A chart review was conducted in 109 patients (women ≥ 18 years old with HR+/HER2- ABC diagnosed between 2015 and 2017) from 11 hospitals. Anonymized data on patient characteristics, treatment patterns and HRU was abstracted.
Mean (range) age of all patients was 57.5 (40-81) years. Overall, the most common first-, second- and third-line systemic therapy after diagnosis of ABC were letrozole ± palbociclib (51%), endocrine therapy (ET)±everolimus (42%) or chemotherapy (ChT) (39%), and ChT (68%), respectively. In patients progressed with ET ( = 33) and those with no prior systemic treatment ( = 52), the most common first-line treatments were letrozole (82%) and letrozole + palbociclib (42%), respectively. The percentage of patients with at least one grade 3 or higher adverse event during first-line therapy was 93.1% vs 39.2% in patients on a ChT based regimen ( = 29) vs. ET ( = 74). Overall, oncologist visits, at an annual rate of 9.27 (95% CI: 8.87, 9.69) visits per month, and hospitalizations, with an annual rate of 0.44 (95% CI: 0.36, 0.54), and mean (SD) length of stay of 14.3 (10.32) days, were the key drivers of HRU.
These findings on real world HRU reflected clinical guidelines and severity of ABC. Results can inform future evaluations of new ABC treatments that estimate the health economic impact of their adoption in Korea.
了解韩国局部晚期或转移性乳腺癌(晚期乳腺癌;ABC)女性患者的当前治疗模式和医疗资源利用(HRU)情况,总体情况以及既往内分泌治疗进展(作为转移性疾病的一线治疗)的患者和未接受过全身治疗(针对晚期疾病)的患者的情况。
对来自11家医院的109例患者(2015年至2017年间诊断为HR+/HER2- ABC且年龄≥18岁的女性)进行病历审查。提取了关于患者特征、治疗模式和HRU的匿名数据。
所有患者的平均(范围)年龄为57.5(40-81)岁。总体而言,ABC诊断后的最常见一线、二线和三线全身治疗分别为来曲唑±哌柏西利(51%)、内分泌治疗(ET)±依维莫司(42%)或化疗(ChT)(39%),以及ChT(68%)。在ET进展的患者(n = 33)和未接受过全身治疗的患者(n = 52)中,最常见的一线治疗分别为来曲唑(82%)和来曲唑+哌柏西利(42%)。在基于ChT方案(n = 29)与ET方案(n = 74)的患者中,一线治疗期间至少发生一次3级或更高等级不良事件的患者百分比分别为93.1%和39.2%。总体而言,肿瘤学家就诊次数,每月年发生率为9.27次(95%CI:8.87,9.69),住院次数,年发生率为0.44次(95%CI:0.36,0.54),平均(SD)住院时长为14.3(10.32)天,是HRU的主要驱动因素。
这些关于真实世界HRU的研究结果反映了ABC的临床指南和严重程度。结果可为未来评估新的ABC治疗方法提供参考,这些评估将估计其在韩国采用后的健康经济影响。