A comparison of treatment allocation and survival between younger and older patients with HER2-overexpressing de novo...

Area of Science:

• Oncology
• Clinical Medicine
• Epidemiology

Background:

• Pivotal trials for HER2-overexpressing metastatic breast cancer often exclude older patients, limiting treatment data for this demographic.
• Understanding age-related differences in treatment and outcomes is crucial for equitable cancer care.

Purpose of the Study:

• To compare treatment allocation and survival outcomes over time in younger versus older patients with HER2-overexpressing metastatic breast cancer.
• To identify disparities in the adoption of novel therapies among different age groups.

Main Methods:

• Analysis of 2,722 patients from the Netherlands Cancer Registry (2005-2021) with de novo metastatic breast cancer.
• Stratification into age groups: <65, 65-74, and ≥75 years.
• Utilized Cox proportional hazard and Poisson models to assess survival outcomes and graphical depiction for treatment trends.

Main Results:

• First-line targeted therapy and chemotherapy use increased significantly across all age groups, with substantial gains by 2021.
• The oldest age group (≥75 years) showed a slower uptake of chemotherapy and targeted therapies compared to younger cohorts.
• Survival improvements were noted in all age groups, but the magnitude of benefit was less pronounced in older patients.

Conclusions:

• While modern therapies for HER2-overexpressing metastatic breast cancer have improved survival across all ages, disparities in treatment uptake persist in older populations.
• Further research and clinical strategies are needed to ensure equitable access and benefit from advancements for elderly cancer patients.