Real-World Patient-Reported Outcomes, Clinical Profile, and Treatment Patterns in a Subset of Patients with HR-Positive, HER2-Negative, Advanced Breast Cancer with Poor Prognostic Factors

2021 Year in Review - HER2-Negative Breast Cancer

Patients with hormone receptor (HR)-positive, HER2-negative, advanced breast cancer who have disease-related poor prognostic factors are not well-documented. A real-world study was performed to describe patient demographics, disease characteristics, treatment patterns, and patient-reported outcomes in a subset of patients with HR-positive, HER2-negative, advanced breast cancer when cyclin-dependent kinase (CDK)4/6 inhibitors were introduced. The aim was to see how these factors influenced treatment decisions at the time of the survey, along with evaluating the demographics, illness features, treatment patterns, and patient-reported outcomes of these patients, with a focus on disease-related poor prognostic variables.

Real-world data came from a comprehensive, global survey of oncologists and their patients with HR-positive, HER2-negative, advanced breast cancer in 5 European Union countries and the United States. The data were gathered between March and June 2017, at the onset of the changing therapy landscape, when CDK4/6 inhibitors were becoming more widely used. Visceral metastases, liver metastases (a subtype of visceral metastases), progesterone receptor–negative status, and high tumor grade were all investigated as unfavorable prognostic variables.

In all, 2259 patients with HR-positive, HER2-negative, advanced breast cancer had records that could be used in this study.1 In 63% of patients, ≥1 adverse prognostic markers were present. The most common adverse prognostic marker was visceral metastases and the least common was progesterone receptor–negative status. There were different degrees of overlap between factors. With the presence of unfavorable prognostic indicators, particularly liver metastases, pain increased and performance status and activities of daily life decreased. There were no evident trends in patient-reported outcomes. As these drugs were being introduced to market, treatment with combined endocrine therapy plus CDK4/6 inhibitors was uncommon at that time.1

The need of administering efficient CDK4/6 inhibitor medication in these individuals is highlighted by their increased pain and impaired performance status. Future research could shed light on how the therapy environment for patients with poor prognostic characteristics has changed over time.


  1. Davie A, Cuyun Carter G, Rider A, et al. Real-world clinical profile, treatment patterns and patient-reported outcomes in a subset of HR+/HER2- advanced breast cancer patients with poor prognostic factors: data from an international study. ESMO Open. 2021;6:100226.

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