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Investigating the Treatment of Metastatic Breast Cancer : = Real-World Evidence on Treatment Patterns, Safety and Efficacy.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Investigating the Treatment of Metastatic Breast Cancer :/
其他題名:	Real-World Evidence on Treatment Patterns, Safety and Efficacy.
作者:	Kessler, Luisa Edman.
面頁冊數:	1 online resource (71 pages)
附註:	Source: Dissertations Abstracts International, Volume: 84-04, Section: A.
Contained By:	Dissertations Abstracts International84-04A.
標題:	Womens health. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=29316545click for full text (PQDT)
ISBN:	9798352603628

Investigating the Treatment of Metastatic Breast Cancer : = Real-World Evidence on Treatment Patterns, Safety and Efficacy.
Kessler, Luisa Edman.

Investigating the Treatment of Metastatic Breast Cancer :Real-World Evidence on Treatment Patterns, Safety and Efficacy. - 1 online resource (71 pages)

Source: Dissertations Abstracts International, Volume: 84-04, Section: A.

Thesis (Ph.D.)--Karolinska Institutet (Sweden), 2022.

Includes bibliographical references

Metastatic breast cancer is an incurable disease causing a spectrum of symptoms and leadingto a continuous deterioration of performance status and quality of life. It is a heterogeneousdisease, with survival being related to tumor biology and patient-related factors. Treatment ofmetastatic breast cancer aims at preventing cancer growth, relieving symptoms, improvingquality of life and prolonging survival, and is most commonly given continuously. Thechoice of treatment depends on tumor subtype, performance status, organ function andcomorbidities. Real world studies describe the effectiveness and safety of different therapiesas well as treatment patterns in routine clinical practice, and can provide valuable informationon the treatment of populations not often enrolled in randomized clinical trials. The aim ofthis thesis was to examine how metastatic breast cancer is treated in the real-world setting,with focus on treatment patterns as well as safety and efficacy of specific agents.Eribulin is a non-taxane microtubule inhibitor approved for the treatment of metastatic breastcancer after progression on at least two prior chemotherapy lines, including anthracyclinesand taxanes. In Paper I, patients treated with eribulin were evaluated regarding efficacy andsafety using data from electronic health records. The results confirmed that eribulin was safeand well tolerated, with a clinical benefit seen in half of the patients. No differences intreatment benefit were seen across histopathologic subgroups.With the aim of investigating treatment with chemotherapy near the end of life in metastaticbreast cancer patients, data were collected from the Stockholm Gotland Breast CancerRegister as well as from electronic health records in Sweden and Greece for Paper II.Chemotherapy use near the end of life was common in both populations. Both orally andintravenously administered regimens were used. In the Swedish cohort, age and albuminlevels were associated with the use of futile chemotherapy, with chemotherapy near the endof life being more commonly administered to younger patients.Several studies have shown a survival benefit for metastatic breast cancer patients treatedwith cyclin dependent kinase 4/6 inhibitors in combination with endocrine treatment. InPaper III, patients treated with cyclin dependent kinase 4/6 inhibitors were assessedregarding efficacy and safety using data from electronic health records. The treatment waswell tolerated, with no new safety signals. However, there was a higher rate of treatmentdiscontinuations than reported in randomized clinical trials. The efficacy of cyclin dependentkinase 4/6 inhibitors was significantly impaired in heavily pretreated patients.In Paper IV, data were collected from the Stockholm Gotland Breast Cancer Register as wellas from electronic health records in order to investigate patients with short survival time aftermetastatic breast cancer diagnosis. One out of six patients with metastatic breast cancersurvived less than three months following diagnosis, and out of those, nearly half did notreceive any antitumor treatment. Patients with short survival time were older and had moreaggressive tumor characteristics and metastatic patterns.Current treatment guidelines recommend that patients with newly diagnosed hormonereceptor positive/human epidermal growth factor receptor 2 negative metastatic breast cancerare treated with endocrine therapy with or without cyclin dependent kinase 4/6 inhibitors,unless presenting with a visceral crisis. In Paper V, with the use of data from the StockholmGotland Breast Cancer Register and the Swedish Prescribed Drug Register, we aimed toinvestigate how patients with hormone receptor positive metastatic breast cancer are treatedin the first line setting. Nearly half of the patients received chemotherapy, in non-adherenceto guidelines. A significantly worse survival was seen in patients treated with chemotherapy,even after adjusting for menopausal status, first metastatic site and distant recurrence freeinterval.In summary, treatment with eribulin as well as with cyclin dependent kinase 4/6 inhibitors inroutine clinical practice was safe, with greater treatment benefit seen in earlier treatmentlines. Treatment of patients with first line chemotherapy instead of endocrine treatment wascommon. Also, use of chemotherapy treatment near the end of life was fairly common,especially in younger patients in the Swedish study population.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2023

Mode of access: World Wide Web

ISBN: 9798352603628Subjects--Topical Terms:

3562508
Womens health.
Index Terms--Genre/Form:

542853
Electronic books.

Investigating the Treatment of Metastatic Breast Cancer : = Real-World Evidence on Treatment Patterns, Safety and Efficacy.
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