Treatment patterns, health care resource use and outcomes in metastatic triple-negative breast cancer in Germany: retrospective chart review study (OBTAIN)

Abstract

Background: There is limited data on the real-life situation and outcomes of patients with metastatic triple-negative breast cancer (mTNBC) in Germany. The aim of this chart review was to describe the current treatment patterns, resource use and outcomes in this patient group.

Methods: Retrospective data collection in 30 gyneco-oncological sites (hospitals and office-based) across Germany between January and April 2017. Index date was defined as initiation of treatment with gemcitabine, vinorelbin, capecitabine or eribulin therapy following discontinuation of taxane and/or anthracycline therapy.

Results: In the 91 evaluable patients, median time between primary diagnosis and index date was 20.9 months (range 0–187 months). Ten percent of patients had no distant metastases, while 57% had newly diagnosed metastases. Cancer stage at index date was mostly IV (82 patients). A number of 135 different regimens (monotherapy or combination therapy) were used. For first-line chemo treatment, 29 patients received monotherapy and 54 patients combination therapy. Bevacizumab and paclitaxel were also the most frequently used single substances among all therapy lines together and for first-line therapy. While taxanes were at least occasionally administered for second-line therapy, no patient received taxanes for third-line therapy. Chemotherapy modifications in terms of dose reduction or treatment interruption were rare. However, the therapy was terminated in more than two thirds of all cases. Fifty-nine patients were hospitalized at least once. For first-, second- and third-line therapy, median overall survival was 19.1/10.8/14.6 months, and median progression-free survival was 7.7/2.5/5.6 months.

Conclusion: In clinical routine, a wide variety of treatment approaches is applied, while outcomes in terms of survival are poor. New treatment options are needed for this challenging tumor type.

Keywords:

• Breast cancer
• treatment
• chemotherapy
• combination
• observational
• chart review
• survival

Transparency

Declaration of funding

This study was sponsored by MSD Sharp & Dohme GmbH, Haar, Germany.

Author contributions

All authors contributed to the design of the study and interpretation of the results. All authors reviewed and approved the final version.

Declaration of financial/other relationships

B.P. has disclosed that she is a full-time employee of MSD, Haar. No potential conflict of interest was reported by the other authors. CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Statement on data sharing: The datasets generated and/or analyzed during the current study are not publicly available as sharing is not explicitly covered by patient consent.

Acknowledgements

The statistical evaluation was carried out by CCRC Düsseldorf.