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.
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.
a 1 Analysis Group, Inc. , 111 Huntington Ave, 10th Floor, Boston, MA 02199, USA +1 617 425 8475 ; +1 617 425 8001 ; peggy.lin@analysisgroup.com.
Peggy L
PL
Lin
b 2 Novartis Pharmaceuticals Corporation , East Hanover, NJ, USA.
Yanni
Y
Hao
c 3 Analysis Group, Inc. , New York, NY, USA.
Jipan
J
Xie
a 1 Analysis Group, Inc. , 111 Huntington Ave, 10th Floor, Boston, MA 02199, USA +1 617 425 8475 ; +1 617 425 8001 ; peggy.lin@analysisgroup.com.
Nanxin
N
Li
a 1 Analysis Group, Inc. , 111 Huntington Ave, 10th Floor, Boston, MA 02199, USA +1 617 425 8475 ; +1 617 425 8001 ; peggy.lin@analysisgroup.com.
Erika
E
Ohashi
a 1 Analysis Group, Inc. , 111 Huntington Ave, 10th Floor, Boston, MA 02199, USA +1 617 425 8475 ; +1 617 425 8001 ; peggy.lin@analysisgroup.com.
Valerie
V
Koo
a 1 Analysis Group, Inc. , 111 Huntington Ave, 10th Floor, Boston, MA 02199, USA +1 617 425 8475 ; +1 617 425 8001 ; peggy.lin@analysisgroup.com.
Eric Q
EQ
Wu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary; D008875:Middle Aged; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*
D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D000068338:Everolimus; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
HR+/HER2- breast cancer; comparative effectiveness; everolimus; liver metastasis; progression-free survival; real world