Real-world effectiveness of everolimus-based therapy versus endocrine monotherapy and chemotherapy in patients of HR+/HER2- breast cancer with liver metastasis in the USA

Abstract

Objective: This study investigated the comparative effectiveness of everolimus-based therapy (EVE) versus endocrine monotherapy (ET) and chemotherapy (CT) in the treatment of hormone-receptor-positive human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC) patients with liver metastasis.

Methods: Medical charts of patients treated by community oncologists were examined. Eligible patients included postmenopausal women with HR+/HER2- mBC with liver metastasis who received EVE, ET or CT between 1 July 2012 and 15 April 2013 after non-steroidal aromatase inhibitor use. Time on treatment (TOT) and progression-free survival (PFS) were compared between EVE and ET or CT using Kaplan–Meier analyses and Cox proportional hazards models.

Results: Among the 202 patients in the study, 82 received EVE, 49 ET, and 71 CT. After adjusting for baseline characteristics, EVE was associated with significantly longer TOT than ET (hazard ratio [HR]: 0.49; 95% CI: 0.28 – 0.86) or CT (HR: 0.35; 95% CI: 0.22 – 0.55), and significantly longer PFS than ET (HR: 0.48; 95% CI: 0.27 – 0.87). PFS was not significantly different with EVE versus CT (HR: 0.76; 95% CI: 0.44 – 1.32).

Conclusions: EVE had significantly longer TOT and PFS than ET and longer TOT than CT among postmenopausal HR+/HER2- mBC patients with liver metastasis.

Keywords:

• comparative effectiveness
• everolimus
• HR+/HER2- breast cancer
• liver metastasis
• progression-free survival
• real world

Declaration of interest

This study was funded by Novartis Pharmaceuticals, Corp. Y Hao is an employee of Novartis Pharmaceuticals, Corp. and owns stock/stock options. PL Lin, J Xie, N Li, E Ohashi, V Koo and EQ Wu are employees of Analysis Group, Inc., which has received consultancy fees from Novartis Pharmaceuticals, Corp. for this project. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Writing assistance was utilized in the preparation of the manuscript and was provided by A Bozas, an employee of Analysis Group, Inc. Novartis ultimately paid for professional medical writing services for this project.

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