Real world evidence study on treatment patterns and health resource utilization in patients with HR+/HER2- locally advanced or metastatic breast cancer in Korea

Abstract

Objective

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).

Methods

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.

Results

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 (n = 33) and those with no prior systemic treatment (n = 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 (N = 29) vs. ET (N = 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.

Conclusions

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.

Keywords:

• Chart review
• HR+/HER2- locally advanced or metastatic breast cancer
• Korea
• real world evidence

Transparency

Declaration of funding

Eli Lilly funded the study.

Declaration of financial/other interests

DN, SYL, and DHK are employees of Eli Lilly. Sam Colman and AS are employees of Covance that received funding from Eli Lilly.

Author contributions

DN: Conceptualization, Methodology, Reviewing, Project Supervision.

SYL: Conceptualization, Reviewing.

DHK: Conceptualization, Reviewing.

AS: Conceptualization, Methodology, Writing, Project Supervision.

SC: Conceptualization, Methodology, Formal Analysis, Writing.

Acknowledgements

None reported.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.