The Evolving Complexity of Treating Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor-2 (HER2)-Negative Breast Cancer: Special Considerations in Older Breast Cancer Patients—Part II: Metastatic Disease

Machine Learning and Real-World Data: More than Just Buzzwords

“…In terms of their strengths, this study rigorously used claims-based data to quantify nonadherence to endocrine therapy in patients with HR + metastatic breast cancer. Studies on nonadherence to these therapies have largely been conducted in the adjuvant setting, [6][7][8] and this study provides important evidence that the nonadherence rate in the metastatic setting, at around 40% during the first year, is largely similar to that in the adjuvant setting. Evaluating therapeutic nonadherence in traditional clinical trials can be costly and may not be representative of adherence in the general population because of the particularly close and stringent follow-up that is inherent to traditional clinical trials; RWD are therefore particularly well-suited to address questions related to adherence as used by Yerrapragada et al in this study.…”

“…Nonadherence to endocrine therapy in HR + breast cancer is thought to be fairly widespread in both the adjuvant and metastatic settings and has been associated with adverse clinical outcomes. [6][7][8] Identifying patients who are likely to be nonadherent to endocrine therapy could allow health care providers to target interventions to these patients to ensure compliance and improve clinical outcomes.…”

Bridging the gap: addressing disparities of access to oncology clinical trials in the geriatric population

“…Designing trials with flexible protocols 11 to accommodate for the needs of older patients could be an alternative to encourage them in participating with local testing options, home visits and telemedicine consults, especially for patients living in rural areas or with reduced mobility. One option could be the conception of trials specifically for older adults, an approach already adopted by several cancer study groups 12 , 13 testing various strategies or evaluating different dose levels later in the drug development. Future trials should adopt a wider vision towards more inclusive endpoints beyond survival, such as quality of life and patient-reported outcomes to ensure an efficient balance between safety and efficacy especially in the geriatric population.…”