Residual Disease Burden After Neoadjuvant Therapy Among US Patients With High-Risk HER2-positive Early-Stage Breast Cancer: A Population Effectiveness Model

Hendrix, Nathaniel; Oestreicher, Nina; Lalla, Deepa; Dolan, Chantal; Fisher, Kathryn; Veenstra, David L.; Moy, Beverly

doi:10.1016/j.clbc.2022.08.012

Cited by 2 publications

(5 citation statements)

References 22 publications

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“…As mentioned earlier, series are increasing over time due to the previously mentioned increase in the size of the population at risk, and substantial shift toward neoadjuvant treatment and away from adjuvant-only treatment. Although not directly comparable due to design differences, our estimates of population-level recurrences in the residual disease population were qualitatively similar to those recently published Hendrix et al [ 44 ].…”

Section: Resultssupporting

confidence: 87%

Impact of Pertuzumab and Ado-Trastuzumab Emtansine on Cumulative Avoidance of Recurrence Among Women Treated for Locally Advanced, Inflammatory, or Early-Stage Nonmetastatic HER2-Positive Breast Cancer in the United States

Sussell¹,

Press²,

Hansen

et al. 2023

Adv Ther

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Introduction We assessed the impact of HER2-positive early breast cancer (EBC) treatment landscape changes following the introduction of pertuzumab and ado-trastuzumab emtansine (T-DM1) on cumulative population-level recurrences avoided since 2013 (first pertuzumab approval for EBC in the United States; US). Methods We constructed a multi-year epidemiologic population treatment-impact model to estimate annual recurrences between 2013 and 2031. Parameters were: BC incidence; stage I–III proportion; HER2-positive disease proportion; treatment proportions for neoadjuvant-only, adjuvant-only, and neoadjuvant–adjuvant continuation; and therapeutic agent proportions within each of those settings (chemotherapy only, trastuzumab ± chemotherapy, pertuzumab with trastuzumab ± chemotherapy, or T-DM1). The primary endpoint was cumulative recurrences, estimated by incorporating extrapolated clinical trial data for each regimen of interest into the model under four scenarios. Results Approximately 889,057 women were predicted to be diagnosed with stage I–III HER2-positive BC from 2006 to 2031 in the US and potentially indicated for HER2-targeted treatment. In steady-state equilibrium, the model estimated that real-world utilization of pertuzumab and T-DM1 will reduce the population-level number of recurrences by approximately 32%, with 7226 recurrences predicted in 2031 based on current utilization rates. In different modeled scenarios, use of neoadjuvant pertuzumab, continuation of pertuzumab in the adjuvant setting, and T-DM1 in the adjuvant setting in women with residual disease after neoadjuvant treatment were all predicted to reduce the number of recurrences. Conclusion Given the improvement of HER2-targeted treatments, alongside increases in BC disease burden, we expect that the population-level impact of HER2-targeted treatments will accelerate over the next decade. Our results suggest that utilization of HER2-targeted treatments in the US has the potential to change the epidemiology of HER2-positive EBC by preventing a substantial number of women from experiencing disease recurrence. These improvements may help to inform our understanding of the future disease and economic burden of HER2-positive BC in the US.

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Section: Resultssupporting

confidence: 87%

Impact of Pertuzumab and Ado-Trastuzumab Emtansine on Cumulative Avoidance of Recurrence Among Women Treated for Locally Advanced, Inflammatory, or Early-Stage Nonmetastatic HER2-Positive Breast Cancer in the United States

Sussell¹,

Press²,

Hansen

et al. 2023

Adv Ther

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“…The findings of this study showed that one of the effective strategies in the treatment of patients with HER2-positive ESBC is T-DM1. Hendrix et al's study (3) showed that despite the significant benefits of T-DM1 therapy, those who do not achieve PCR, face significant clinical risk over the next 10 years, particularly in the first 5 years after treatment. Diaby et al's study (21) showed that the first line as trastuzumab plus docetaxel, and then in the second and third lines, the use of TDM1 and trastuzumab plus lapatinib are the most cost-effective strategies.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 15 to 30% of patients with early-stage breast cancer (ESBC) have human epidermal growth factor receptor 2 (HER2) protein overexpression and/or HER2 gene amplification positive disease, which is associated with a poor prognosis (2)(3)(4).…”

Section: Contextmentioning

confidence: 99%

“…Twenty-one studies were included from 14 countries. Seven studies were conducted in the United States (3,(15)(16)(17)(18)(19)(20), 2 studies were conducted in Taiwan (21, 22), and 12 other studies were conducted in Brazil (23), Canada (24), China (25), Germany (26), Italy (27), Japan (28), Macedonia (29), Mexico (30), Portugal (31), Russia (32), Singapore (33), and Spain (34).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The economic evaluation analysis model used in the studies was different; 11 studies have used the Markov model (18,19,21,22,24,25,27,29,30,32,34), 3 studies have used the decision-analytic model (decision trees) (3,15,16), 2 studies have used partitioned survival (28,33), 1 study has used Binary logistic regression model (31), 1 study has used combined decision tree (decision-analytic) and partitioned survival (area under the curve) (20), 1 study has used hybrid decision-tree/Markov (17), and 2 studies have not used any model (23,26).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Economic Evaluation of Neoadjuvant Treatment Strategies for HER2 Positive Breast Cancer: A Systematic Review

Akbari,

Seyednezhad,

Heidari

et al. 2023

Int J Cancer Manag

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Context: There are several neoadjuvant treatment strategies for HER2-positive breast cancer (BC). Studies have investigated different aspects of these strategies and presented different findings. Objectives: This study aimed at collecting and interpreting economic evaluation studies related to neoadjuvant treatment strategies for HER2-positive BC. Methods: In this systematic review, PubMed, Web of Science (WOS), ScienceDirect, and Scopus databases were searched without a time limit between May and October 2023. Google Scholar search engine was also used to complete the search process. Two authors independently determined the eligibility of the study. To assess the quality of the studies, the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines were used. Disagreements were resolved by discussion or consultation with a third researcher. As this review is descriptive, numerical data were not extracted for statistical analysis. Results: Out of 234 studies found in the first stage, 21 studies from 14 countries were included. The strategies that have been approved by studies include THP (taxol, trastuzumab, pertuzumab), PTD (Pertuzumab in combination with trastuzumab and docetaxel), TH (docetaxel and trastuzumab), T-DM1 (trastuzumab emtansine), and HP (trastuzumab plus pertuzumab). Conclusions: The findings of this systematic review show that the reported strategies in the treatment of HER2-positive BC patients are cost-effective in different settings. While the findings of this review provide largely positive results, the characteristics of each strategy should be considered.

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Residual Disease Burden After Neoadjuvant Therapy Among US Patients With High-Risk HER2-positive Early-Stage Breast Cancer: A Population Effectiveness Model

Cited by 2 publications

References 22 publications

Impact of Pertuzumab and Ado-Trastuzumab Emtansine on Cumulative Avoidance of Recurrence Among Women Treated for Locally Advanced, Inflammatory, or Early-Stage Nonmetastatic HER2-Positive Breast Cancer in the United States

Impact of Pertuzumab and Ado-Trastuzumab Emtansine on Cumulative Avoidance of Recurrence Among Women Treated for Locally Advanced, Inflammatory, or Early-Stage Nonmetastatic HER2-Positive Breast Cancer in the United States

Economic Evaluation of Neoadjuvant Treatment Strategies for HER2 Positive Breast Cancer: A Systematic Review

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