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Title: Uptake of bone modifying agents in patients with HER2+ metastatic breast cancer with bone metastases - prospective data from a multi-site Australian registry.
Austin Authors: Wong, Vanessa ;de Boer, Richard;Dunn, Catherine;Anton, Angelyn;Malik, Laeeq;Greenberg, Sally;Yeo, Belinda ;Nott, Louise;Collins, Ian M;Torres, Javier;Barnett, Frances;Nottage, Michelle;Gibbs, Peter;Lok, Sheau Wen
Affiliation: Walter and Eliza Hall Institute of Medical Research, Victoria, Australia
St Vincent's Private Hospital, Victoria, Australia
Eastern Health, Victoria, Australia
Western Health, Victoria, Australia
Peter MacCallum Cancer Centre, Victoria, Australia
The Northern Hospital, Victoria, Australia
Goulburn Valley Health, Shepparton, Victoria, Australia
South West Healthcare, Warrnambool, Victoria, Australia
Olivia Newton-John Cancer Research Institute
Walter and Eliza Hall Institute of Medical Research, VIC
Epworth-Freemasons Hospital, VIC
Ballarat Health Services, Victoria, Australia
Canberra Hospital, ACT..
Royal Hobart Hospital, TAS..
Royal Brisbane and Womens' Hospital, QLD..
Issue Date: 18-May-2021
Date: 2021
Publication information: Internal Medicine Journal 2022; 52(10)
Abstract: International practice guidelines recommend administration of bone modifying agents (BMA) in metastatic breast cancer (MBC) patients with bone metastases to reduce skeletal related events (SRE). Optimal delivery of BMA in routine clinical practice including agent selection and prescribing intervals remains unclear. We aim to describe real-world practice of Australian breast oncologists. Prospective data from February 2015 to July 2020 on BMA delivery to MBC patients with bone metastases was analysed from TABITHA, a multi-site Australian HER2+ MBC registry. Of 333 HER2+ MBC patients, 171 (51%) had bone metastases at diagnosis, with a mean age of 58.1 years [range 32-87]. 130 (76%) patients received a BMA, with 90 (69%) receiving denosumab and 40 (31%) receiving a bisphosphonate. Patients who received a BMA were more likely to have received concurrent first line systemic anti-HER2 therapy (95% vs 83%, p=0.04), to present with bone-only metastases at diagnosis (24% vs 7%, p=0.02) and less likely to have visceral metastases (51% vs 71%, p=0.03). Ten of 40 (25%) bisphosphonate patients and 45 of 90 (50%) denosumab patients received their BMA at the recommended 4-weekly interval. Prescribing intervals varied over time. Adverse events reported were consistent with clinical trial data. Three-quarters of Australian HER2+ MBC patients with bone metastases receive a BMA, often at different schedules than guidelines recommend. Further studies, including of all MBC subtypes, are warranted to better understand clinicians' prescribing rationale and potential consequences of current prescribing practice on SRE incidence. This article is protected by copyright. All rights reserved.
DOI: 10.1111/imj.15376
ORCID: 0000-0002-4323-8786
Journal: Internal Medicine Journal
PubMed URL: 34002929
Type: Journal Article
Subjects: breast cancer
HER2+ metastatic breast cancer
bone modifying agents
Appears in Collections:Journal articles

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