Abstract P6-07-10: Healthcare resource used in metastatic HER2+ breast cancer patients initiating an oral anticancer treatment
Authors: Espie M , Lortholary A , Woronoff-Lemsi M-C , Flinois A , Chabernaud H , Dramard-Goasdoue M-H , Benjamin L , Merrouche Y 
Published: August 2014

Background: Data on the healthcare resource used among patients treated with oral anticancer treatments (OAT) are not well known and may be assumed to be different from patients receiving treatments including an intravenous (IV) treatment. We compared treatment patterns of patients exclusively treated with OAT to that of patients receiving oral and IV anticancer treatments in HER2+ metastatic Breast Cancer (mBC) patients.

Methodology: A prospective observational multicenter study was conducted in France among 284 HER2+ mBC patients, treated by 68 oncologists, initiating a treatment including an OAT. Data were collected on clinical characteristics, treatment patterns, adherence, quality-of-life and healthcare resources upon treatment initiation, and then every three months over a maximum follow-up period of 9 months. The analysis was conducted on 211 patients for which the information was available on the entire follow-up period. Among them 117 were treated with OAT only and 94 with an oral + IV anticancer treatment.

Results:

Patients treated with OAT only received more frequently concomitant treatments, especially hormonal-therapy (33.3% versus 11.7% for patients receiving oral + IV treatment, p = 0,001). The number of healthcare professional consultations was significantly different between the two groups (p = 0,017) with a higher percentage of consultations for the OAT group excepted for psychiatrists/psychologists and nutritionists/dieticians consultations. The prescription of supportive care treatments did not vary significantly between the two groups (p&gt;0.05).

Treatments & consultations for each group OAT only (n = 117)Oral + IV (n = 94)p-value (1)Concomitant treatment (2), % (n)  0,001Hormonal-therapy (HT)33.3% (39)11.7% (11) Radiotherapy (RT)16.2% (19)17.0% (16) Neither RT nor HT55.6% (65)76.6% (72) Supportive care treatments % (n)  0.737Bisphosphonates29.1% (34)35.1% (33) Antiemetics36.8% (43)40.4% (38) Erythropoietin16.2% (19)21.3% (20) Analgesics17.9% (21)12.8% (12) Granulocyte colony-stimulating factor8.5% (10)10.6% (10) Consultations with other healthcare professionals, % (n)  0.017General Practitioners66.7% (78)60.6% (57) Nurse of which51.3% (60)35.1% (33) * Visiting Nurse31.6% (37)21.3% (20) * Practice Nurse17.1% (20)13.8% (13) * Unspecified15.4% (18)12.8% (12) Radiologist41.9% (49)36.2% (34) Psychiatrist / Psychologist36,8% (43)40.4% (38) Physiotherapist38,5% (45)17.0% (16) Radiotherapist28.2% (33)14.9% (14) Nutritionists / Dietician16.2% (19)28.7% (27) Gynaecologist6.8% (8)3.2% (3) (1) : Chi-2 test. The p-values were calculated on the category and not for each item. (2) : Patients receiving HT and RT concomitantly were counted both as HT and RT.

Conclusions:

The results of this study show that patients with HER2+ mBC treated exclusively with OAT have significantly higher healthcare professionals’ outpatient consultations to manage their disease knowing that patients receiving IV treatment may consume more hospital resources related to the administration of the product such as hospitalizations. These data tend to confirm the greater involvement of general practitioners and nurses in the care of patients treated orally as these patients require more support to manage their treatment.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-07-10.