MammaPrint risk score distribution in South African breast cancer patients with the pathogenic BRCA2 c.7934delG founder variant: towards application of genomic medicine at the point-of-care

Abstract

Goals: Study aimed to show physician experiences and preferences in the treatment of HR+/Her2- metastatic breast cancer. Methods: 100 Egyptian oncologists were recruited from an online survey and scientific meetings. Physician characteristics such as work place, years of practice experience, the preferred used guidlines and their estimates of median survival of these patients. Prescribing patterns Physicians’ therapeutic preferences for the treatment of their HR +/HER2- mBC patients were collected by asking physicians about their preferred therapy by treatment class (ET vs. CT), treatment regimen (individual agents, monotherapy vs. combination therapy), line of therapy, and by early (first or second line) versus later lines. Reasons of treatment choices Information was collected on the reasons underlying physicians’ treatment decisions. Results: Based on physician recall, endocrine therapy was the most preferred first line therapy reported by 89.7% of physicians. The most preferred treatments reported by physicians for second‐line therapy included a different endocrine combination therapy (58.8%). For subsequent line treatment, the most preferred treatments were CT monotherapy. Among endocrine therapies, aromatase inhibitors were the most frequently used first line ET(52.1%). For second line treatment, 21% of surveyed physicians indicated a preference for fulvestrant+ CDK4/ 6inhibitor. For third‐line treatment, 19% of physicians indicated a preference for exmestene + Mtor inhibitors. Among CT treatments, paclitaxel was the most frequently used agent across third and fourth lines of therapy, followed by capecitabine. Conclusion(s): The treatment patterns reported by the physicians were generally consistent with treatment guidlines recommenda- tions. For patients with HR+/HER2-mBC, phydicians typically pre- scribed median of two lines of ET prior to CT initiation. After first line ET, monotherapy or combination ET was commonly used in the second line, and CT monotherapy in the third or later lines of treatment. For patients with visceral symptoms, physicians were more likely to prescribe CT as early lines of treatment. Aromatase inhibitors were the most preferred first line ET, fulvestrant based therapy in the second line treatment and everolimus based therapy in the third line of treatment. But, paclitaxel and capecitabine were the most commonly used CTs in the third or later lines of treatment.