Systemic therapy, survival and end-of-life costs for metastatic triple-negative breast cancer: retrospective SEER-Medicare study of women age ≥65 years

Future Oncol. 2021 Jul;17(20):2581-2592. doi: 10.2217/fon-2021-0019. Epub 2021 Mar 25.

Abstract

Aim: To analyze therapy for metastatic triple-negative breast cancer (mTNBC), factors contributing to survival and costs. Patients & methods: Using 2010-2016 SEER-Medicare data, we identified women (≥65 years) with mTNBC. Results: Of 302 eligible patients, 152 (50%) received systemic therapy. In multivariable regression analyses, only age <75 years was associated with therapy receipt (odds ratio: 2.91; 95% CI: 1.79-4.74); and only systemic therapy significantly reduced risk of death (hazard ratio: 0.34; 95% CI: 0.26-0.44). Median overall survival was 13.4 (95% CI: 11.3-15.1) vs 3.3 months (95% CI: 2.7-3.9) in therapy vs no-therapy cohorts. Mean per-patient-per-month costs <30 days before end-of-life/follow-up were $14,100 and $15,600 (2019 USD), respectively. Conclusion: Poor outcomes and high costs indicate need for more effective mTNBC therapy.

Keywords: costs; metastatic triple-negative breast cancer; observational; retrospective study; survival; systemic anticancer therapy.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / economics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms, Male / drug therapy*
  • Breast Neoplasms, Male / economics
  • Breast Neoplasms, Male / mortality
  • Breast Neoplasms, Male / pathology
  • Drug Costs / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Medicare / economics
  • Medicare / statistics & numerical data
  • Middle Aged
  • Retrospective Studies
  • SEER Program / statistics & numerical data
  • Survival Analysis
  • Terminal Care / economics*
  • Terminal Care / methods
  • Terminal Care / statistics & numerical data
  • Triple Negative Breast Neoplasms / drug therapy*
  • Triple Negative Breast Neoplasms / economics
  • Triple Negative Breast Neoplasms / mortality
  • Triple Negative Breast Neoplasms / secondary
  • United States / epidemiology

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