Treatment patterns, clinical outcomes, health resource utilization, and cost in patients with BRCA-mutated metastatic breast cancer treated in community oncology settings

Cancer Treat Res Commun. 2019:19:100121. doi: 10.1016/j.ctarc.2019.100121. Epub 2019 Feb 6.


Purpose: This retrospective study of community oncology patients with breast cancer gene (BRCA)-mutated metastatic breast cancer (MBC) examined treatment outcomes and health resource utilization (HRU) and costs for a sample of patients with human epidermal growth factor receptor 2 (HER2)-negative disease who were either hormone receptor positive (HR+) or triple negative breast cancer (TNBC).

Methods: Evidence from the Vector Oncology Data Warehouse, a repository of electronic medical records/billing data and provider notes, was analyzed. Treatment outcomes were progression-free survival (PFS) and overall survival (OS) from start of first-line therapy in the metastatic setting. HRU and cost measures were collected from the time of MBC diagnosis to end of the record. HRU included hospitalizations, emergency room visits, infused/parenteral supportive care drugs, and outpatient visits. Costs were computed both as total and monthly costs.

Results: 57 HR+ and 57 TNBC patients (2013-2015) met inclusion criteria. Eight TNBC patients did not get treatment. HR+ patients had median first line PFS of 12.1 months and TNBC patients had 6.1 months. HR+ patients had median OS from start of first line of 38.4 months, and TNBC patients had 23.4 months. Rate of use of infused/parenteral supportive care drugs was 25.5% overall and 36.7% among TNBC patients with 15.8% among HR+ patients.

Conclusion: There is an unmet need in BRCA-mutated patients with MBC, including those with HR+ and TNBC disease. The unmet need among TNBC patients was most evident in that 12% were not treated and TNBC patients appeared to have poor treatment outcomes.

Micro abstract: Reviewed medical records for outcomes, resource utilization, and costs in 114 community patients with BRCA mutated metastatic breast cancer. 57 hormone positive (HP); 57 triple negative (TN).

Results: median PFS: 12.1 months HP; 6.1 TN. HP OS was 38.4; TN 23.4. Rate of infused supportive care drugs: 25.5% HP; 36.7% TN. Patients with TN disease need better therapeutic options.

Keywords: BRCA-mutated breast cancer; Clinical outcomes; Cost; Health resource utilization; Treatment patterns.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / economics*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • BRCA1 Protein / genetics*
  • BRCA2 Protein / genetics*
  • Biomarkers, Tumor / genetics
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / economics
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / drug therapy
  • Carcinoma, Ductal, Breast / economics
  • Carcinoma, Ductal, Breast / genetics
  • Carcinoma, Ductal, Breast / secondary
  • Carcinoma, Lobular / drug therapy
  • Carcinoma, Lobular / economics
  • Carcinoma, Lobular / genetics
  • Carcinoma, Lobular / secondary
  • Community Health Centers
  • Costs and Cost Analysis*
  • Female
  • Follow-Up Studies
  • Health Care Rationing / economics
  • Health Care Rationing / statistics & numerical data*
  • Humans
  • Inflammatory Breast Neoplasms / drug therapy
  • Inflammatory Breast Neoplasms / economics
  • Inflammatory Breast Neoplasms / genetics
  • Inflammatory Breast Neoplasms / secondary
  • Middle Aged
  • Mutation*
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome


  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human
  • Biomarkers, Tumor