Industry Encore
Olivia Adams
Stemline 1
Background: Breast cancer continues to have a large impact on the global burden in terms of morbidity and healthcare resource utilization (HRU). Endocrine therapy (ET) + CDK4/6i is the mainstay for the management of ER+/HER2- mBC as 1st-line (1L) therapy; however, tumors eventually develop resistance to ET. ESR1 mutations (ESR1-mut) represent a type of acquired resistance in up to 40% of pts that predominantly occur after ET, particularly aromatase inhibitors, reducing the efficacy of available regimens. In the EMERALD trial, elacestrant (ELA) was associated with significantly prolonged PFS and a manageable safety profile vs SOC ET in pts with ER+/HER2-, ESR1-mut adv/mBC, leading to the first oral SERD approved. Pts receiving ELA demonstrated a mPFS of 3.8 mos vs 1.9 mos with SOC ET (Bidard, 2022). Pts who received ≥12 mos of prior CDK4/6i experienced a PFS of 8.6 mos with ELA vs 1.9 mos with SOC ET (SABCS, 2022). Understanding the resource implications of ELA as a novel treatment strategy is essential for healthcare decision-makers, providers, and pts.
Methods: A decision analytic model estimated the clinical events and HRU offsets resulting from treating pts with ELA over a 3-year time horizon. This analysis estimated the average number of pts with disease progression following ≥1 line of ET treated at a facility each year. Outcomes included number of deaths, AEs, hospital days due to AEs, fulvestrant administration, outpatient visits, inpatient visits, ER visits, and lost hours avoided, including number of pts requiring subsequent treatment. The model analyzed a scenario in which the current treatment mix of eligible pts converted to ELA.
Results: Among ~500 breast cancer pts per facility, 21 pts were estimated to be eligible for treatment each year, totaling 64 pts over the modeled time horizon. ELA led to a reduction in the number of clinical events, with 1 death and 27 Grade ≥3 AEs avoided. Reductions in HRU were observed with 131 fewer hospital days, 791 fewer fulvestrant administrations, and a reduction in 1,449 outpatient, 215 inpatient, and 55 ER visits. The number of hrs of missed work avoided and activity impairment avoided were estimated to be 5,853 hrs and 6,082 hrs, respectively.
Conclusions: This decision analytic model demonstrated that treating pts with ELA resulted in a meaningful reduction in the number of clinical and healthcare resource utilization events while showing improvements in work productivity and activities of daily living.