gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Physicians’ Treatment Strategies in Breast Cancer Chemotherapy: The BEAM Drug Utilization Study in Germany

Meeting Abstract

  • corresponding author presenting/speaker Thomas Bauknecht - Lilly Deutschland GmbH, Bad Homburg, Deutschland
  • Karin Helsberg - Lilly Deutschland GmbH, Bad Homburg
  • Frank Kessler - Lilly Deutschland GmbH, Bad Homburg
  • Frank Langer - Lilly Deutschland GmbH, Bad Homburg
  • Claudia Nicolay - Lilly Deutschland GmbH, Bad Homburg
  • Christian Jackisch - Klinikum Offenbach

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO034

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dkk2006/06dkk144.shtml

Veröffentlicht: 20. März 2006

© 2006 Bauknecht et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objectives: The objectives of this German drug utilization study (Breast Cancer Treatment Evaluation in Advanced and Metastatic Disease, BEAM) were to evaluate the treatment strategies physicians use for first- and second-line treatment of metastatic and/or locally advanced breast cancer in a naturalistic setting.

Methods: Between October 2003 and March 2005, 94 physicians prospectively documented diagnostic and anamnestic data, planned and actual treatment regimens, tumor response and overall outcome (improved, unchanged, worsened) for 448 female breast cancer patients in Germany. All treatment decisions were completely at the physicians’ discretion. All analyses were conducted using descriptive statistics.

Results: Of 94 participating physicians, 63 were oncologists (55 practice- and 8 hospital-based), 21 gynecologists (8 practice- and 13 hospital-based) and 10 of unknown specialty. In this patient cohort of 448 breast cancer patients (age 30-88 yrs, 95.1% metastatic disease, 27.5% primary metastatic, 67.9%prior chemotherapy, 44.0% prior anthracycline treatment, 89.1% classified as high-risk) physicians used a wide variety of 66different chemotherapy regimens (see Table [Tab. 1]), with 41 of them used in 1‑4cases only. Gemcitabine (GEM) combinations, which were used in 17.6% of all pts, were most frequently used as doublet with paclitaxel in accordance with the current GEM labeling (19.5% of N=123 GEM pts), but also as doublets with cisplatin (12.2%), vinorelbine (7.3%), docetaxel (6.5%) or herceptin (5.7%). Physicians preferred anthracycline-based combinations as first-line treatment in lower risk patients, whereas GEM was used more frequently second-line in higher risk patients. Response rates and overall outcome were consistently better in patient populations with combination treatment than with the respective single agent (overall: CR+PR 37.6% vs. 19.2%, pts improved 38.7% vs. 24.0%), while discontinuation rates due to toxicity were in a similar range (5.2% vs. 6.9%).

Conclusions: In this drug utilization study, physicians used a wide variety of 66 different single agent and combination treatments. Patient risk and prior treatment were identified as major criteria for treatment decision. Corresponding to results from clinical studies, treatment outcomes observed in the naturalistic setting were consistently more favourable in patient populations with combination than with single agent treatment.