title: Treatment patterns and factors associated with the use of everolimus among post-menopausal women with HR+/HER2- metastatic breast cancer: a retrospective US claims study.
abstract: OBJECTIVE
  To assess the real-world use of everolimus in the treatment of hormone-receptor-positive/human-epidermal-growth-factor-receptor-2-negative (HR+/HER2-) metastatic-breast-cancer (mBC).
  
  
  METHODS
  Postmenopausal women with HR+/HER2- mBC who initiated a new therapy for mBC between 20 July 2012 and 31 March 2014 after a non-steroidal-aromatase-inhibitor were identified from two commercial claims databases. Multivariate logistic regressions were used to identify factors associated with everolimus use versus endocrine-monotherapy or chemotherapy. Dosing patterns and adherence to everolimus were summarized.
  
  
  RESULTS
  A total of 940 everolimus, 6,134 endocrine-monotherapy, and 3,410 chemotherapy regimens were included across patients' first four lines of therapy. Patients with bone and visceral metastases were more likely to use everolimus versus endocrine-monotherapy. Patients with more comorbidities, visceral or central-nervous-system metastases, and prior chemotherapy use for mBC were less likely to use everolimus versus chemotherapy. Approximately 80% of patients initiated everolimus at label-recommended-dose of 10 mg daily; 60-70% of patients had a medical possession ratio >0.8 to everolimus, and consistently high adherence was observed across lines of therapy.
  
  
  CONCLUSIONS
  For HR+/HER2- mBC, patients treated with everolimus had more severe disease than patients treated with endocrine-monotherapy but less severe disease than patients treated with chemotherapy. Most patients used everolimus according to label-recommended dose and adherence was high across lines of therapy.
authors.affiliation: a Analysis Group, Inc ., Montreal , Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.affiliation: b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Yanni
authors.initials: Y
authors.lastname: Hao
authors.affiliation: b Novartis Pharmaceuticals Corporation , East Hanover , NJ , USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Tang
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Miranda
authors.initials: M
authors.lastname: Peeples
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Fang
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kageleiry
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Valerie
authors.initials: V
authors.lastname: Koo
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Nanxin
authors.initials: N
authors.lastname: Li
authors.affiliation: c Analysis Group, Inc ., Boston , MA , USA.
authors.forename: Eric Q
authors.initials: EQ
authors.lastname: Wu
mesh_terms: D000067575:Administrative Claims, Healthcare / Q000706:statistics & numerical data; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D016208:Databases, Factual; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D017698:Postmenopause; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D016903:Drug Monitoring
chemical_list: D000068338:Everolimus; D018719:Erb-b2 Receptor Tyrosine Kinases
keywords: Chemotherapy; Everolimus; endocrine monotherapy; metastatic breast cancer; post-menopausal; treatment patterns