e13600 Background: Adenoid cystic carcinoma (ACC) is a rare malignancy of the secretory glands, accounting for approximately 1% of head and neck cancers and 10% of salivary gland neoplasms. ACC primarily occurs in the major and minor salivary glands; however, it is found in other sites of the head and neck, breast, female genital tract, prostate and skin. There is limited scientific literature on the epidemiology of ACC and no published incidence or prevalence estimates across all anatomic sites. Methods: Using data from the Surveillance, Epidemiology, and End Results (SEER) 18 registries, ACC cases were identified by International Classification of Diseases for Oncology 3rd Edition histology codes. Data from 2012-2016 were used to estimate age-adjusted incidence rates (IR) and 5-year limited duration prevalence (LDP). Data from 2000-2016 were used to approximate 16-year LDP. IR and LDP were estimated overall and by age, sex and race. IR was calculated for each anatomic site. Total incident and prevalent cases were projected using the 2020 US Census population. Analyses were conducted in SEER*Stat (v8.3.6) and SAS 9.4. Results: In the US, ACC age-adjusted IR was 0.35 per 100,000 and 5- and 16-year LDP were 1.48 and 3.24 per 100,000, respectively (Table). ACC IR and LDP (per 100,000) were highest in those aged 75-79 years (IR 1.45; 5-year LDP 5.82; 16-year LDP 14.25) and in females, and lowest among Native Americans/Alaska Natives. ACC IR (per 100,000) were highest in the oral cavity and pharynx (IR 0.19), salivary glands (IR 0.12), respiratory system (IR 0.07) and breast (IR 0.05). As of January 1, 2020, 10,777 patients were living with ACC in the US who had been diagnosed 2000-2016. Conclusions: This study describes the US epidemiology of ACC across all anatomic sites and provides incidence and prevalence estimates not currently published in the literature. Improving understanding of the epidemiology of this rare cancer has important implications for the development of effective clinical and public health interventions. [Table: see text]
e18695 Background: The treatment paradigm for advanced HR+/HER2- breast cancer has been rapidly evolving since the approval of the first CDK4/6 inhibitor in the U.S. in 2015. Available literature on real-world utilization of various treatment options available to these patients remains limited. The objective of this study was to describe how advanced HR+/HER2- breast cancer treatment patterns have changed over time since the approval of novel CDK4/6 inhibitors. Methods: IBM MarketScan Research Databases, a nationally representative source of U.S. insurance claims data, was used to identify women diagnosed with advanced breast cancer between January 2015 and December 2019 via ICD-9/10 codes. Algorithms were applied to capture patients with HR+/HER2- subtype and advanced disease diagnosis. Patients were indexed on their advanced breast cancer diagnosis date and were required to have six months continuous enrollment in the insurance claims database prior to and after the index date to ensure patients included in the cohort were alive and contributed at least 12 months of data for analysis. Lines of therapy (LOTs) were constructed and treatment patterns were reported over time. Descriptive analyses were conducted using Instant Health Data software. Results: A total of 4,128 women (mean age: 58 years, IQR: 50-64 years) had received at least one systemic breast cancer treatment and were included in the analysis. During a mean follow-up time of two years, nearly 29% of patients received at least four LOTs for advanced disease. A high number of unique regimens were reported in each LOT (30 in 1L, 48 in 2L, 53 in 3L and 50 in 4L+). The distribution of the top 1L regimens changed significantly over time (Table). CDK4/6 inhibitor use in the 2L setting also increased substantially from 43% in 2015 to 68% in early 2019, while chemotherapy and endocrine monotherapy utilization decreased. Conclusions: These data reflect a significant shift in the treatment landscape for HR+/HER2- advanced breast cancer patients in real-world practice since the availability of CDK4/6 inhibitors. However, there remains significant heterogeneity in the use of other treatments in these patients and in treatment sequencing, suggesting potential unmet need with current therapies. Further insight into patient, clinical and community-level factors guiding treatment decisions in the real world is needed. [Table: see text]
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