title: ReCAP: Treatment Patterns and Cost of Care Associated With Initial Therapy Among Patients Diagnosed With Operable Early-Stage Human Epidermal Growth Factor Receptor 2-Overexpressed Breast Cancer in the United States: A Real-World Retrospective Study.
abstract: OBJECTIVE
  Overexpression of the human epidermal growth factor receptor 2 (HER2) protein negatively affects survival in breast cancer. This study aimed to assess real-world treatment patterns and costs associated with resected nonmetastatic HER2-positive breast cancer in the United States.
  
  
  METHODS
  Commercially insured patients with HER2-positive breast cancer were identified from oncology registry data linked to a large US commercial administrative claims database. Treatment patterns and health care use and costs in the initial phase of care were examined.
  
  
  RESULTS
  Among the 915 patients who met the study criteria, 662 (72%) were hormone receptor (HR) positive, and 253 (28%) were HR negative. Overall, 72% (n = 662) of patients received HER2-targeted therapy (HR positive, 69% v HR negative, 80%; P < .01), specifically trastuzumab. The most common treatment regimens, regardless of HR status, were carboplatin, docetaxel, and trastuzumab (47% of patients) during neoadjuvant therapy and carboplatin, docetaxel, and trastuzumab ± hormone therapy (30% of patients) during adjuvant therapy. Overall unadjusted cost of treatment per patient per month (HR positive, $11,906 v HR negative, $14,367; P < .001) was mainly cancer related (HR positive, $10,513 v HR negative, $13,073; P < .001). Adjusted 12-month cost was $176,779 (HR positive, $167,088 v HR negative, $180,226; P > .05).
  
  
  CONCLUSIONS
  Although trastuzumab-based therapy is considered standard of care among patients with HER2-positive early-stage breast cancer, approximately 28% of these patients did not receive HER2-targeted therapy. Additional studies are warranted to examine whether patients who have not received targeted therapy are eligible for and would benefit from an HER2-targeted approach.
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA Stacey.DacostaByfield@optum.com.
authors.forename: Stacey
authors.initials: S
authors.lastname: DaCosta Byfield
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Philip O
authors.initials: PO
authors.lastname: Buck
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Cori
authors.initials: C
authors.lastname: Blauer-Peterson
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Poston
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA stacey.dacostabyfield@optum.com.
authors.forename: Stacey
authors.initials: S
authors.lastname: DaCosta Byfield
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Philip O
authors.initials: PO
authors.lastname: Buck
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Cori
authors.initials: C
authors.lastname: Blauer-Peterson
authors.affiliation: Optum, Eden Prairie, MN; and GlaxoSmithKline, Philadelphia, PA.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Poston
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D003131:Combined Modality Therapy; D016208:Databases, Factual; D005260:Female; D015870:Gene Expression; D017048:Health Care Costs; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases