Patient-reported Quality of Life and Treatment Satisfaction in Patients With HR+/HER2- Advanced/Metastatic Breast Cancer

Abstract

Purpose: Globally, around 1.67 million new cases of breast cancer are diagnosed each year, with advanced breast cancer (ABC-Stage III) and metastatic breast cancer (MBC-Stage IV) together accounting for up to 22% of incident cases. Hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR⁺/HER2^-) breast cancer comprises 66% of ABC/MBC. Understanding disease-specific health-related quality of life and patient satisfaction with treatments currently available for HR⁺/HER2^- ABC/MBC in clinical practice is essential for assessing potential unmet need in this patient population.

Methods: Data on treatment patterns in patients with HR⁺/HER2^- ABC/MBC were collected from oncology practices across the United States and Europe in a cross-sectional study in a clinical practice setting, the Adelphi Real World Advanced Breast Cancer Disease Specific Programme. A subset of patients included in the study completed several self-reported tools, including the Functional Assessment of Cancer Therapy-Breast and the Cancer Therapy Satisfaction Questionnaire. Analyses were conducted using data from the overall cohort and stratified by current treatment, metastatic sites, and number of prior therapy lines.

Findings: Overall, 739 patients were recruited by 173 oncologists; 83% of patients had MBC, with the balance having ABC. The majority of patients with MBC had visceral metastases without bone metastases, and similar percentages of the total study population (≈40%) were receiving chemotherapy and endocrine therapy. Patients receiving only endocrine therapy had significantly better cancer-specific quality of life than did those receiving chemotherapy. Endocrine therapy also associated with fewer concerns about side effects and higher treatment satisfaction than chemotherapy. Statistically lower scores, indicating poorer well-being, were observed in patients with both bone and visceral metastases compared with those with either bone-only or visceral-only metastases for all but the Social/Family Well-Being and Functional Well-Being domains of the Functional Assessment of Cancer Therapy-Breast. Patients with bone and visceral metastases had significantly greater concerns about treatment side effects than those with metastases at other sites. Receipt of a greater number of prior lines of therapy was associated with poorer well-being scores. There was a significant negative association between number of lines of treatment and treatment expectations.

Implications: Findings from this study from clinical practice suggest that treatment outcomes in HR⁺/HER2^- ABC/MBC could be optimized through improved understanding of the impact that components of patient care have on health-related quality of life and treatment satisfaction.

Keywords: Advanced breast cancer; health-related quality of life; metastatic breast cancer; real-world; treatment satisfaction.