Back to Archived Journals » Comparative Effectiveness Research » Volume 5

Treatment characteristics and mortality of a large insured female population with advanced or metastatic breast cancer by receipt of HER2-targeted agents

Authors Hao Y, Meyer N, Landsman-Blumberg P, Johnson W, Willemann Rogerio J

Received 25 August 2014

Accepted for publication 18 October 2014

Published 28 April 2015 Volume 2015:5 Pages 35—47


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Corrine I Voils

Yanni Hao,1 Nicole Meyer,2 Pamela Landsman-Blumberg,2 William Johnson,2 Jaqueline Willemann Rogerio1

1Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA; 2Truven Health Analytics, Cambridge, MA, USA

Purpose: This retrospective administrative claims study of women diagnosed with advanced or metastatic breast cancer compared treatment characteristics and mortality by receipt of human epithelial growth factor receptor 2 (HER2)-targeted agents and by disease stage and age group among patients using HER2-targeted agents.
Patients and methods: Adult women diagnosed with stage III or IV breast cancer (index date) between 2008 and 2012 were identified from MarketScan® databases containing medical and pharmacy claims for >40 million enrollees insured with >100 US health plans. Patients were followed until the earlier of the following: end of enrollment, inpatient death, or December 31, 2012. Study cohorts were women ± HER2-targeted agent use, HER2-targeted agent users' subgroups of stages III and IV, and age group. Pre- and postindex breast cancer treatments were compared among study cohorts. Overall survival was compared using log-rank tests. Cox proportional-hazards models were used to study the predictors of overall survival.
Results: Of 30,660 eligible women, 14.4% received HER2-targeted agents. HER2-targeted agent users received more aggressive pre- and postindex cancer treatments compared to those with no HER2-targeted agents. HER2-targeted agents had higher rates of pre- and postindex breast cancer surgery, adjuvant/neoadjuvant chemotherapy, radiation therapy, chemotherapy, and biologics-based therapy. Among HER2-targeted agent users, younger women and those with stage III breast cancer received more aggressive treatments. After adjusting for clinically relevant patient characteristics, women receiving HER2-targeted agents had a 20% reduced risk of death compared to patients not receiving HER2-targeted agents. Among all patients and the subset of HER2-targeted agent users, stage IV patients and those in the oldest age group had a higher risk of death.
Conclusion: Among patients with advanced or metastatic breast cancer, receipt of HER2-targeted agents was associated with more aggressive treatment and longer survival. Patients with higher stage breast cancer and older patients received less aggressive therapies and had a higher risk of death.

Keywords: metastatic breast cancer, HER2, treatment, survival, human epidermal growth factor receptor 2, therapy

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]