Abstract PS10-47: Physician and patient satisfaction with poly(ADP-ribose) polymerase inhibitors (PARPi) versus chemotherapy in adult patients with germline BRCA1/2 mutated (gBRCA1/2mut) HER2- advanced breast cancer (ABC): Results from a multi-country real-world (RW) study
Authors: Lux Michael Patrick , Niyazov Alexander , Lewis Katie , Pike James , Rider Alex , Arondekar Bhakti , Mahtani Reshma 
Published: February 2021

Background: Within the past 3 years, PARPi have demonstrated improved progression-free survival and favorable PROs compared with chemotherapy in randomized clinical trials in patients with gBRCA1/2mut HER2- ABC. These agents are now available in multiple countries for the treatment of gBRCA1/2mut HER2- locally advanced and/or metastatic breast cancer. Limited information is available on physician/patient satisfaction with PARPi from the RW. We assessed RW physician/patient treatment satisfaction among adult patients with gBRCA1/2mut HER2- ABC in Germany, France, Italy, Spain (EU4), US, and Israel.

Methods: Oncologist were recruited to abstract data from medical records (2019/2020) for patients with gBRCA1/2mut HER2- ABC. Physicians were asked to rank (1=very dissatisfied to 5=very satisfied) their satisfaction with their patient’s current ABC treatment. The scores were dichotomized to a 0/1 variable (0=very dissatisfied/ dissatisfied/moderately satisfied; 1=satisfied/very satisfied). A subset of patients completed the Cancer Treatment Satisfaction Questionnaire, a validated instrument that was used to measure patient’s satisfaction with their current therapy. The physician and patient sample were matched. Physician/patient satisfaction scores were compared between chemotherapy and PARPi monotherapy utilizing inverse probability weighted regression adjustment controlling for age at therapy initiation, Charlson Comorbidity Index at time of data collection, baseline symptoms, hormone receptor (HR) status, ECOG score at therapy initiation, stage of therapy initiation (locally advanced breast cancer or metastatic breast cancer) and number of lines of ABC treatment.

Results: Overall 96 adult female patients participated; mean age was 51 years. Tumor characteristics were: 34.4% HR+/HER2-, 65.6% triple negative breast cancer. Chemotherapy (n=58) was received among 60.4% of pts [n=29 (50.0%) platinum based, n=29 (50.0%) non-platinum based], and PARPi monotherapy (n=38) was received among 39.6% of pts. Physicians were significantly more likely to be satisfied or very satisfied with PARPi in comparison with chemotherapy (95.4% vs. 40.8%, p&lt;0.001). Mean patient satisfactions scores were numerically higher with PARPi vs. chemotherapy: expectation of therapy 81.3 vs. 72.0 (p=0.13), feelings about side effects 55.7 vs. 51.4 (p=0.30), satisfaction with therapy 74.0 vs. 68.5 (p=0.13).

Conclusions: PARPi have demonstrated superior efficacy and favorable PROs vs. chemotherapy in randomized controlled trials. In this RW study, physicians reported significantly higher satisfaction with PARPi vs. chemotherapy; patients reported numerically higher satisfaction scores with PARPi vs. chemotherapy across all domains. These findings further support the value of PARPi in patients with gBRCA1/2mut HER2- ABC. Additional studies to validate these findings are planned.

Funding: Pfizer

Citation Format: Michael Patrick Lux, Alexander Niyazov, Katie Lewis, James Pike, Alex Rider, Bhakti Arondekar, Reshma Mahtani. Physician and patient satisfaction with poly(ADP-ribose) polymerase inhibitors (PARPi) versus chemotherapy in adult patients with germline BRCA1/2 mutated (gBRCA1/2mut) HER2- advanced breast cancer (ABC): Results from a multi-country real-world (RW) study [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS10-47.