Tracking Utilization of Neoadjuvant Endocrine Therapy (NET) and Neoadjuvant Chemotherapy (NCT) for Hormone...

Area of Science:

• Oncology
• Breast Cancer Research
• Clinical Therapeutics

Background:

• Hormone receptor-positive breast cancer (HR+BC) is a significant subtype.
• Neoadjuvant endocrine therapy (NET) offers a less toxic alternative to neoadjuvant chemotherapy (NCT) for HR+BC.
• Previous data indicated limited growth in NET utilization.

Purpose of the Study:

• To investigate the utilization trends of NET, NCT, and no neoadjuvant therapy (no NT) in HR+BC patients.
• To compare the usage patterns across different age groups (≤50 and ≥51 years).
• To analyze trends from 2005 to 2023 using real-world data.

Main Methods:

• Utilized the TriNetX database for HR+BC patients (stages I-III, ER+, PR+, ERBB2-) undergoing mastectomies.
• Evaluated the utilization rates of NET, NCT, and no NT.
• Trend analysis was performed for different age cohorts, excluding the initial period due to data limitations.

Main Results:

• NET use remained below 1%, significantly lower than NCT (approx. 11%).
• Breast conserving surgery was more frequent with NET than NCT (p < .0001).
• While NCT use declined in both age groups, NET patterns remained stable, and no NT increased, suggesting masked subgroup trends.

Conclusions:

• NET is significantly underutilized in HR+BC despite its proven benefits.
• Low toxicity and efficacy of NET warrant increased consideration as a primary treatment option.
• Further initiatives are crucial to bridge the gap in NET adoption for eligible patients.