Abstract PO3-16-11: Attrition rates from first- to third-line therapy in HER2+ metastatic breast cancer in Europe
Notice bibliographique
Résumé
Abstract Background: Patients (pts) with human epidermal growth factor receptor 2 (HER2)-positive (HER2+) metastatic breast cancer (mBC) who experience progression with adjuvant first-line (1L) therapy (trastuzumab, pertuzumab, and a taxane) typically require treatment escalation. Trastuzumab emtansine was standard of care in the second-line (2L) setting until the recent approval (Jul 2022 in the EU) of trastuzumab deruxtecan in ≥2L settings. Receiving optimal targeted therapy in the earliest indicated setting is important to maximize the likelihood of durable clinical benefit. As new therapies become available, understanding subsequent lines of therapy may help guide treatment decision making and inform the optimal treatment paradigm for pts with HER2+ mBC. This study characterizes contemporary attrition rates in pts with HER2+ mBC receiving routine care in Europe. Methods: In this ongoing, multicenter, observational study, electronic medical record (EMR) data were collected from female pts ≥18 years old diagnosed with HER2+ mBC between Jan 1, 2017, and Jun 30, 2021, in the UK, France, Germany, Italy, and Spain. Structured EMR data and manually abstracted unstructured data from oncology centers were curated. Pts were followed for ≥12 months from mBC diagnosis. Data analysis is ongoing. The primary endpoint was attrition rate (percentage of pts who completed a line of therapy [LOT] but did not receive the subsequent LOT after 1L and 2L therapy). Documented reasons for attrition included death or move to end-of-life palliative care, end of study period, loss to follow up, or discontinuation due to toxicity. Reasons were categorized as ‘other’ if they did not meet these criteria, or if death or move to end-of-life palliative care occurred >30 days after treatment discontinuation. This abstract reports interim data from the UK, France, and Germany. Results: This interim analysis included data from 335 pts across five sites in three countries: two sites in the UK, one in France, and two in Germany (Table). Overall, 307 (91.6%) pts started 1L therapy and 172 (51.3%) pts started 2L therapy; overall attrition rates were 28.9% (70/242; 95% CI 23.3, 35.1) after 1L therapy and 33.1% (42/127; 95% CI 25.0, 42.0) after 2L therapy. The proportion of pts starting 1L and 2L therapy and attrition rates for each country are shown in the Table. Overall reasons for attrition were death (1L, n=28 [40.0%]; 2L, n=12 [28.6%]), move to end-of-life palliative care (1L, n=14 [20.0%]; 2L, n=5 [11.9%]), toxicity (1L, n=2 [2.9%]; 2L, n=1 [2.4%]), loss to follow up (1L, n=6 [8.6%]; 2L, n=4 [9.5%]), end of study period (1L, n=1 [1.4%]; 2L, n=4 [9.5%]), and other (1L, n=19 [27.1%]; 2L, n=16 [38.1%]). Further breakdown of results by country and hormone receptor (HR) status is shown in the Table. Conclusions: These data from routine clinical practice in the UK, France, and Germany indicate that a substantial proportion of pts with HER2+ mBC who completed 1L or 2L therapy did not receive a subsequent LOT (2L or 3L, respectively) for reasons other than death or move to end-of-life palliative care. Future analyses will focus on pooled and country-level treatment rates and real-world effectiveness. XX XX Citation Format: Peter Hall, Sue Cheeseman, Paul Cottu, Markus Krebs, Christian Scholz, Mahéva Vallet, Nicolas Niklas, Catherine Hogg, Markus Lucerna, Simon M Collin, Amanda Logue, Gráinne Long. Attrition rates from first- to third-line therapy in HER2+ metastatic breast cancer in Europe [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-16-11.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,019 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».