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.
