title: Everolimus-Based Therapy versus Chemotherapy among Patients with HR+/HER2- Metastatic Breast Cancer: Comparative Effectiveness from a Chart Review Study.
abstract: Objective. To compare the real-world effectiveness of everolimus-based therapy and chemotherapy in postmenopausal women with hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic breast cancer (mBC). Methods. This retrospective chart review examined a nationwide sample of postmenopausal HR+/HER2- mBC women in community-based oncology practices. Patients received everolimus-based therapy or chemotherapy for mBC between 07/01/2012 and 04/15/2013, after failure of a non-steroidal aromatase inhibitor. Overall survival (OS), progression-free survival (PFS), and time on treatment (TOT) were compared using Kaplan-Meier analysis and Cox proportional hazards models adjusting for line of therapy and baseline characteristics. Results. 234 and 137 patients received everolimus-based therapy and chemotherapy. Patients treated with everolimus-based therapy tended to have less aggressive mBC than patients treated with chemotherapy. Multivariate-adjusted Cox models showed that everolimus-based therapy was associated with significantly longer OS [hazard ratio (HR) = 0.37, 95% confidence interval (CI): 0.22-0.63], PFS (HR = 0.70, 95% CI = 0.50-0.97), and TOT (HR = 0.34, 95% CI: 0.25-0.45) than chemotherapy. Adjusted comparative effectiveness results were generally consistent across lines of therapy. Conclusion. In this retrospective chart review of postmenopausal HR+/HER2- mBC patients, treatment with everolimus-based therapy was associated with longer OS, PFS, and TOT than chemotherapy.
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA.
authors.forename: Nanxin
authors.initials: N
authors.lastname: Li
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ 07936, USA.
authors.forename: Yanni
authors.identifier: 0000-0002-2300-9951
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Analysis Group, Inc., New York, NY 10020, USA.
authors.forename: Jipan
authors.initials: J
authors.lastname: Xie
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA.
authors.forename: Peggy L
authors.initials: PL
authors.lastname: Lin
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Koo
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA.
authors.forename: Erika
authors.initials: E
authors.lastname: Ohashi
authors.affiliation: Analysis Group, Inc., Boston, MA 02199, USA.
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu