24 Patient Preferences for CDK4/6 Inhibitor Treatments in HR+/HER2– Early Breast Cancer: A Discrete Choice Survey Study

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement41st Annual Miami Breast Cancer Conference® - Abstracts
Volume 38
Issue 4
Pages: 27-28

Background

Patients with stage II/III hormone receptor–positive (HR+)/HER2-negative (HER2–) early breast cancer (EBC) are at risk of recurrence that persists over years. The addition of a CDK4/6 inhibitor to adjuvant endocrine therapy (ET) was studied in the phase 3 monarchE trial, which assessed abemaciclib (ABE), and the phase 3 NATALEE trial (NCT03701334), which assessed ribociclib (RIB). Abemaciclib was FDA approved for this indication in 2021, and NATALEE recently reported statistically significant invasive disease-free survival (iDFS) results. This study evaluated the extent to which patients in the United States value treatment attributes and how these translate into preferences among 2 CDK4/6 inhibitors, ribociclib, and abemaciclib.


Methods

A web-based discrete choice experiment survey was conducted from January to May 2023. Patients were adult women with self-reported stage II/III HR+/HER2– EBC with or without prior chemotherapy receiving only adjuvant ET at the time of the survey. Patients selected scenarios from choice cards, each with 2 hypothetical treatment profiles. A total of 8 attributes related to efficacy (5-year iDFS), adverse effects (AEs; risk of diarrhea, fatigue, or venous thromboembolic events [VTE]), monitoring (number of electrocardiograms [EKG] or blood tests), treatment duration (2 years vs 3 years), and schedule (once daily, intermittent vs twice daily, continuous) were included. A conditional logistic regression model was used to estimate the relative importance (RI) of each attribute. Utility scores were estimated for the model with various scenarios tested.

Results

Survey Results

Survey Results

A total of 409 patients participated in the survey (median age,
53 years; White/Black/other race, 59%/23%/23%; BC stage II/III, 48%/52%; employed, 38%). Patient preferences for attributes in order of high to low RI were 5-year iDFS, risk of diarrhea, risk of fatigue, shorter treatment duration, and risk of VTE. The number of blood tests, number of EKGs, and treatment schedule did not affect treatment choice. Overall utility scores were consistently higher for treatment profiles that resembled RIB features, including in conservative scenarios where efficacy was assumed to be equivalent/lower with ABE.

Conclusions

This study showed that driven by a preference for lower risk of AEs, patients prefer treatment profiles that more closely resemble the clinical experience with ribociclib. These patient preferences are important for shared decision-making when considering the addition of a CDK4/6 inhibitor to adjuvant treatment for patients with HR+/HER2– EBC.

Articles in this issue

1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
1 Centrally Located Breast Cancer Is More Aggressive in Bahraini Patients
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
2 Is Laterality in Breast Cancer Still Worth Studying? Local Experience in Bahrain
3 Gender Disparities in the  National Institutes of Health  Funding for Breast Cancer
3 Gender Disparities in the National Institutes of Health Funding for Breast Cancer
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
4 Bacopaside: Exploring Its Potential in Addressing Chemoresistance and Modulating Doxorubicin Accumulation in Triple-Negative Breast Cancer Cells
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
5 Predictors of Axillary Complete Pathologic Response in Hormone Receptor–Positive, HER2-Negative, Clinically Node-Positive Breast Cancer
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
6 Treatment Outcomes of the KEYNOTE-522 Regimen in an Ethnically Diverse Patient Population
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
7 Real-World Efficacy and Adverse Events of Neoadjuvant Immunotherapy in Early-Stage Triple-Negative Breast Cancer Patients: A Multicenter Experience
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
8 Using a Liquid Biopsy Mediated Approach for Determination of HER2 Amplification Status in Patient Samples
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
9 Elacestrant (ELA) vs Standard-of-Care (SOC) in ER+/HER2–Advanced (adv) or Metastatic Breast Cancer (mBC) with ESR1 Mutation (ESR1-mut): Key Biomarkers and Clinical Subgroup Analyses From the Phase 3 EMERALD Trial
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
10 Real-World Effectiveness of Palbociclib (PAL) Plus Aromatase Inhibitors (AI) in Patients With Metastatic Breast Cancer (MBC) and Cardiovascular Diseases (CVD)
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
11 Phase 3 Study of Neoadjuvant Pembrolizumab or Placebo Plus Chemotherapy, Followed by Adjuvant Pembrolizumab or Placebo Plus Endocrine Therapy for Early-Stage High-Risk ER+/HER2– Breast Cancer: KEYNOTE-756
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast  Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
12 EMERALD Trial Analysis of Patient-Reported Outcomes (PROs) in Patients (pts) With ER+/HER2- Advanced or Metastatic Breast Cancer (mBC) Comparing Oral Elacestrant vs Standard-of-Care (SoC) Endocrine Therapy
13 The Cause and Eradication of Breast Cancer
13 The Cause and Eradication of Breast Cancer
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
14 Outcomes With First-Line (1L) Ribociclib (RIB) + Endocrine Therapy (ET) vs Physician’s Choice Combination Chemotherapy (combo CT) by Age in Pre/Perimenopausal Patients (pts) With Aggressive HR+/HER2– Advanced Breast Cancer (ABC): A Subgroup Analysis of the RIGHT Choice Trial
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
15 Concurrent Use of Abemaciclib and Radiation Therapy (RT) Among Patients With HR+, HER2– Metastatic Breast Cancer (MBC): Real-World Utilization and Safety
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