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Article: Patterns of colorectal cancer screening and adherence rates among an average-risk population enrolled in a national health insurance provider during 2009-2018 in the United States.

Kowalkowski, Henrik / Austin, George / Guo, Yinglong / Miller-Wilson, Lesley-Ann / DaCosta Byfield, Stacey

2023 Volume 36, Page(s) 102497

Abstract: While colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US), outcomes can be improved through timely screening. Despite the benefits and widespread availability of screening tests, adherence to ... ...

Abstract	While colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States (US), outcomes can be improved through timely screening. Despite the benefits and widespread availability of screening tests, adherence to recommended screening strategies is low. The study aimed to provide recent evidence regarding screening rates and adherence to screening recommendations among adults at average risk for CRC in a commercially insured and Medicare Advantage population. De-identified administrative data from a large US research database were examined to determine screening rates for the years 2009 through 2018. The study population included adults aged 50-75 years and annual study population counts ranged from 1,390,594 in 2009 to 1,654,544 in 2018. Incident screening rates were found to be relatively stable across the study years (approximately 15 %) with adherence lowest in the youngest age group (ages 50-54 years). Colonoscopies accounted for approximately 50 % of all screening tests performed, while there was a substantial increase in the use of home-based screening tests over the study timeframe. The use of the fecal immunochemical test increased from 17.2 % in 2009 to 28.9 % in 2018 and the multi-target stool DNA test increased from 0.4 % in 2015 to 9.0 % in 2018. Overall though, CRC screening and adherence rates remain relatively low among adults at average risk for CRC in the US. Improving adherence rates with CRC screening recommendations among individuals at average risk for CRC is required to improve health outcomes.
Language	English
Publishing date	2023-11-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2785569-7
ISSN	2211-3355
ISSN	2211-3355
DOI	10.1016/j.pmedr.2023.102497
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Article ; Online: Economic impact of multigene panel testing for hereditary breast and ovarian cancer.

Byfield, Stacey Dacosta / Wei, Helen / DuCharme, Mary / Lancaster, Johnathan M

Journal of comparative effectiveness research

2021 Volume 10, Issue 3, Page(s) 207–217

Abstract: Aim: ...

Abstract	Aim:
MeSH term(s)	Breast Neoplasms/diagnosis ; Breast Neoplasms/genetics ; Carcinoma, Ovarian Epithelial ; Female ; Genetic Predisposition to Disease ; Genetic Testing ; Humans ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/genetics ; Retrospective Studies
Language	English
Publishing date	2021-01-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2042-6313
ISSN (online)	2042-6313
DOI	10.2217/cer-2020-0192
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Article ; Online: Adverse Events and Economic Burden Among Patients Receiving Systemic Treatment for Mantle Cell Lymphoma: A Real-World Retrospective Cohort Study.

Kabadi, Shaum M / Byfield, Stacey Dacosta / LE, Lisa / Olufade, Temitope

Anticancer research

2021 Volume 41, Issue 2, Page(s) 927–936

Abstract: Background/aim: Limited published real-world data describe adverse events (AEs) among patients treated for mantle-cell lymphoma (MCL). The aim of this retrospective study was to describe treatment patterns, AEs, and associated healthcare costs.: ... ...

Abstract	Background/aim: Limited published real-world data describe adverse events (AEs) among patients treated for mantle-cell lymphoma (MCL). The aim of this retrospective study was to describe treatment patterns, AEs, and associated healthcare costs. Patients and methods: Patients had two or more claims coded for MCL diagnosis, the first claim date (07/01/2012-05/31/2017) was the index date. Patients with pre-index MCL diagnosis or systemic treatment, or hematopoietic stem cell transplantation were excluded. Cohorts by regimen were followed for up to three lines of therapy. Results: Patients (n=395; median age 72 years; 31% female) were observed over a total of 576 lines of therapy, the most common being bendamustine plus rituximab; rituximab monotherapy; R-CHOP; and ibrutinib. The most frequent AEs were hypertension (40.5%), anemia (37.7%), and infection (36.1%). However, hepatotoxicity ($19,645), stroke ($18,893), and renal failure ($9,037) were associated with the highest medical costs per patient per month. Conclusion: Among patients receiving common systemic treatments for MCL, AEs occurred frequently; some imposed substantial inpatient care costs.
MeSH term(s)	Adenine/adverse effects ; Adenine/analogs & derivatives ; Adenine/economics ; Adenine/therapeutic use ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/economics ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bendamustine Hydrochloride/adverse effects ; Bendamustine Hydrochloride/economics ; Bendamustine Hydrochloride/therapeutic use ; Chemical and Drug Induced Liver Injury/economics ; Cyclophosphamide/adverse effects ; Cyclophosphamide/economics ; Cyclophosphamide/therapeutic use ; Doxorubicin/adverse effects ; Doxorubicin/economics ; Doxorubicin/therapeutic use ; Female ; Health Care Costs ; Humans ; Lymphoma, Mantle-Cell/drug therapy ; Male ; Middle Aged ; Piperidines/adverse effects ; Piperidines/economics ; Piperidines/therapeutic use ; Prednisone/adverse effects ; Prednisone/economics ; Prednisone/therapeutic use ; Renal Insufficiency/chemically induced ; Renal Insufficiency/economics ; Retrospective Studies ; Rituximab/adverse effects ; Rituximab/economics ; Rituximab/therapeutic use ; Stroke/chemically induced ; Stroke/economics ; Vincristine/adverse effects ; Vincristine/economics ; Vincristine/therapeutic use
Chemical Substances	Piperidines ; R-CHOP protocol ; ibrutinib (1X70OSD4VX) ; Rituximab (4F4X42SYQ6) ; Vincristine (5J49Q6B70F) ; Doxorubicin (80168379AG) ; Cyclophosphamide (8N3DW7272P) ; Bendamustine Hydrochloride (981Y8SX18M) ; Adenine (JAC85A2161) ; Prednisone (VB0R961HZT)
Language	English
Publishing date	2021-01-23
Publishing country	Greece
Document type	Journal Article
ZDB-ID	604549-2
ISSN	1791-7530 ; 0250-7005
ISSN (online)	1791-7530
ISSN	0250-7005
DOI	10.21873/anticanres.14846
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Article ; Online: Patterns of initial colorectal cancer screenings after turning 50 years old and follow-up rates of colonoscopy after positive stool-based testing among the average-risk population.

Austin, George / Kowalkowski, Henrik / Guo, Yinglong / Miller-Wilson, Lesley-Ann / DaCosta Byfield, Stacey / Verma, Prat / Housman, Laura / Berke, Ethan

Current medical research and opinion

2022 Volume 39, Issue 1, Page(s) 47–61

Abstract: Objectives: Effective colorectal cancer (CRC) screening requires proper adherence beginning at the recommended screening age. For those with positive results on stool-based tests (SBTs), a follow-up colonoscopy is warranted. The objectives of this study ...

Abstract	Objectives: Effective colorectal cancer (CRC) screening requires proper adherence beginning at the recommended screening age. For those with positive results on stool-based tests (SBTs), a follow-up colonoscopy is warranted. The objectives of this study were to 1) examine initial screening rates after turning 50 years old; and 2) assess rates of follow-up colonoscopy after a positive SBT. Methods: This retrospective study used de-identified administrative claims data from 01/01/2006 to 06/30/2020 for commercially insured and Medicare Advantage enrollees. For objective 1, the index year was the year enrollees turned 50. Rates of CRC screening during and after the index year were captured. For objective 2, the index date was the claim date of a fecal immunochemical test (FIT) or multitarget stool DNA test (mt-sDNA) where linked lab data indicated a positive test result. Rates and time to follow-up colonoscopy after a positive SBT were assessed. Results: Approximately 53% of enrollees initiated CRC screening within five years after turning 50 (50+ cohort Conclusion: There is potential for improving CRC screening among the eligible average-risk population, both to start screening once they reach the screening-eligible age, and to complete the CRC screening paradigm after a positive stool-based screen.
MeSH term(s)	Humans ; United States ; Aged ; Middle Aged ; Retrospective Studies ; Follow-Up Studies ; Early Detection of Cancer/methods ; Medicare ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/genetics ; Mass Screening/methods
Language	English
Publishing date	2022-09-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80296-7
ISSN	1473-4877 ; 0300-7995
ISSN (online)	1473-4877
ISSN	0300-7995
DOI	10.1080/03007995.2022.2116172
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Article ; Online: Real-World Outcomes and Value of First-Line Therapy for Metastatic Non-Small Cell Lung Cancer

DaCosta Byfield, Stacey / Chastek, Benjamin / Korrer, Stephanie / Horstman, Thomas / Malin, Jennifer / Newcomer, Lee

Cancer investigation

2020 Volume 38, Issue 10, Page(s) 608–617

Abstract: Although physicians rely on clinical trial data to guide cancer treatment decisions, patient characteristics and outcomes often differ between real-world and clinical trial populations. We analyzed retrospective clinical data collected from a prior ... ...

Abstract	Although physicians rely on clinical trial data to guide cancer treatment decisions, patient characteristics and outcomes often differ between real-world and clinical trial populations. We analyzed retrospective clinical data collected from a prior authorization (PA) tool linked with payer claims data to describe outcomes of first-line treatment for metastatic non-small cell lung cancer among 2,108 patients. Duration of therapy was shorter than observed in clinical trials. Healthcare costs and hospitalizations varied substantially by regimen. PA clinical data linked with administrative claims enable head-to-head comparisons of contemporary cancer treatments used in routine clinical practice, which are not available from clinical trials.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/secondary ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/mortality ; Lung Neoplasms/pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Rate
Language	English
Publishing date	2020-10-27
Publishing country	England
Document type	Journal Article
ZDB-ID	604942-4
ISSN	1532-4192 ; 0735-7907
ISSN (online)	1532-4192
ISSN	0735-7907
DOI	10.1080/07357907.2020.1827415
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Article ; Online: Comparison of Germline Genetic Testing Before and After a Medical Policy Covering Universal Testing Among Patients With Colorectal Cancer.

Moretz, Chad / Byfield, Stacey DaCosta / Hatchell, Kathryn E / Dalton, Joline / Onglao, Peter Nicholas / Hang, Lillian / Hansen, Pamela / Radford, Cristi / Nielsen, Sarah M / Heald, Brandie / Munro, Sandra B / Nussbaum, Robert L / Esplin, Edward D

JAMA network open

2022 Volume 5, Issue 10, Page(s) e2238167

Abstract: Importance: In 2020, some health insurance plans updated their medical policy to cover germline genetic testing for all patients diagnosed with colorectal cancer (CRC). Guidelines for universal tumor screening via microsatellite instability and/or ... ...

Abstract	Importance: In 2020, some health insurance plans updated their medical policy to cover germline genetic testing for all patients diagnosed with colorectal cancer (CRC). Guidelines for universal tumor screening via microsatellite instability and/or immunohistochemistry (MSI/IHC) for mismatch repair protein expression for patients with CRC have been in place since 2009. Objectives: To examine whether uptake of MSI/IHC screening and germline genetic testing in patients with CRC has improved under these policies and to identify actionable findings and management implications for patients referred for germline genetic testing. Design, setting, and participants: The multicenter, retrospective cohort study comprised 2 analyses of patients 18 years or older who were diagnosed with CRC between January 1, 2017, and December 31, 2020. The first analysis used an insurance claims data set to examine use of MSI/IHC screening and germline genetic testing for patients diagnosed with CRC between 2017 and 2020 and treated with systemic therapy. The second comprised patients with CRC who had germline genetic testing performed in 2020 that was billed under a universal testing policy. Main outcomes and measures: Patient demographic characteristics, clinical information, and use of MSI/IHC screening and germline genetic testing were analyzed. Results: For 9066 patients with newly diagnosed CRC (mean [SD] age, 64.2 [12.7] years; 4964 [54.8%] male), administrative claims data indicated that MSI/IHC was performed in 6645 eligible patients (73.3%) during the study period, with 2288 (25.2%) not receiving MSI/IHC despite being eligible for coverage. Analysis of a second cohort of 55 595 patients with CRC diagnosed in 2020 and covered by insurance found that only 1675 (3.0%) received germline genetic testing. In a subset of patients for whom germline genetic testing results were available, 1 in 6 patients had pathogenic or likely pathogenic variants, with most of these patients having variants with established clinical actionability. Conclusions and relevance: This nationwide cohort study found suboptimal rates of MSI/IHC screening and germline genetic testing uptake, resulting in clinically actionable genetic data being unavailable to patients diagnosed with CRC, despite universal eligibility. Effective strategies are required to address barriers to implementation of evidence-based universal testing policies that support precision treatment and optimal care management for patients with CRC.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Colorectal Neoplasms, Hereditary Nonpolyposis/genetics ; Cohort Studies ; Retrospective Studies ; Microsatellite Instability ; Genetic Testing/methods ; Germ Cells ; Policy
Language	English
Publishing date	2022-10-03
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2022.38167
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Article: A retrospective cohort study of treatment patterns among patients with metastatic soft tissue sarcoma in the US.

Villalobos, Victor M / Byfield, Stacey DaCosta / Ghate, Sameer R / Adejoro, Oluwakayode

Clinical sarcoma research

2017 Volume 7, Page(s) 18

Abstract: Background: Since treatment patterns in metastatic soft tissue sarcoma (mSTS) have not been studied subsequent to US approval of pazopanib in 2012, this study sought to examine mSTS treatment patterns by line of therapy, including regimen and duration ... ...

Abstract	Background: Since treatment patterns in metastatic soft tissue sarcoma (mSTS) have not been studied subsequent to US approval of pazopanib in 2012, this study sought to examine mSTS treatment patterns by line of therapy, including regimen and duration of therapy. Methods: This retrospective study employed administrative claims from a large US health plan from 1/2006-9/2015. Adult mSTS patients were required to have an NCCN-recommended therapy and be continuously enrolled in the health plan during the study period. The most frequent regimens for distinct lines of therapy (LOT) were assessed. Sensitivity analyses evaluated changes to study findings using two alternate medical and pharmacy claims diagnostic algorithms to define the STS study population. Results: Among 555 patients with mSTS, mean age was 59 years and 54% were male. During the study period, 41% of patients initiated ≥ 2 LOTs; 16% had ≥ 3 LOTs and 5% had ≥ 4 LOTs. Docetaxel + gemcitabine was most common in LOT1, pazopanib in LOT2 and LOT3, and doxorubicin in LOT4. The five most common LOT1 regimens represented 53% of patients; among the remaining 47%, the most common regimen represented < 6% of patients. Among patients with pazopanib in LOT2 and LOT3, the most common prior regimen was docetaxel + gemcitabine (47% and 30% respectively). Kaplan-Meier estimation of median treatment duration overall for LOT1 was 3.5 months, while for LOT2 and LOT3, median treatment duration was 2.9 and 3.3 months, respectively. For both sensitivity analyses, patient demographic and clinical characteristics were similar to the original study population, and the five most frequently used regimens in LOT1 and LOT2 were similar among the three populations regardless of the population selection criteria employed. Conclusion: Choice of regimen by LOT among patients with mSTS is varied; < 65% of patients in any LOT received the five most common regimens. Pazopanib, the only approved targeted therapy, is primarily used in second and later lines of therapy and is mostly given post docetaxel + gemcitabine.
Language	English
Publishing date	2017-11-09
Publishing country	England
Document type	Journal Article
ZDB-ID	2623217-0
ISSN	2045-3329
ISSN	2045-3329
DOI	10.1186/s13569-017-0084-4
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Article ; Online: Real-World Treatment Patterns Among Patients Initiating Small Molecule Kinase Inhibitor Therapies for Thyroid Cancer in the United States.

Dacosta Byfield, Stacey A / Adejoro, Oluwakayode / Copher, Ronda / Chatterjee, Debanjana / Joshi, Prashant R / Worden, Francis P

Advances in therapy

2019 Volume 36, Issue 4, Page(s) 896–915

Abstract: Introduction: Little is known about real-world use of small molecule kinase inhibitors (SMKI) for advanced thyroid cancer in the United States. This study examined prescribing patterns of SMKI agents recommended by the National Comprehensive Cancer ... ...

Abstract	Introduction: Little is known about real-world use of small molecule kinase inhibitors (SMKI) for advanced thyroid cancer in the United States. This study examined prescribing patterns of SMKI agents recommended by the National Comprehensive Cancer Center (NCCN). Methods: This retrospective study used a national health insurance database to identify patients diagnosed with thyroid cancer during 1/1/2006-6/30/2016 and with prescription claims for NCCN-recommended SMKI during 1/1/2010-5/31/2016 whose first claim date was the index date. Inclusion also required continuous enrollment in a health plan for 3 months pre-index (baseline) and ≥ 1 month post-index (follow-up) with no claims for SMKI during baseline. Lines of therapy (LOT) were defined by the date of SMKI claims and days of drug supply. Median time to SMKI discontinuation in each LOT was estimated by Kaplan-Meier method. Results: The study included 217 patients. During follow-up (mean duration 499.0 days), 35.5% of patients (n = 77) received a second or later LOT; among patients with ≥ 12 months follow-up after first LOT (LOT1) initiation, 53.1% (n = 60) received a second or later LOT. Median treatment duration was 5.0 months for LOT1 and 5.1 months for LOT2. Over the entire follow-up period (2010-2016), sorafenib was the most common regimen in LOT1 (36.9% of patients) and LOT2 (24.7%) followed by sunitinib and levantinib (13.4% each) in LOT1 and sunitinib (19.5%) in LOT2. Starting in 2015, the year lenvatinib was approved for differentiated thyroid cancer, lenvatinib was the most common first-line regimen among patients initiating LOT1 in 2015 (43.4%) and 2016 (66.7%). Conclusion: Sorafenib was the most common first-line agent during 2010-2014 but was supplanted by lenvatinib starting in 2015. Approximately 36-53% of patients received a second-line treatment. Median treatment duration results suggested potential benefit of SMKI in second-line therapy. SMKI treatment after first-line failure may be considered for appropriately selected patients. Funding: Eisai, Inc. (Woodcliff Lake, NJ).
MeSH term(s)	Databases, Factual/statistics & numerical data ; Drug Utilization Review/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Molecular Targeted Therapy/methods ; Phenylurea Compounds/therapeutic use ; Practice Patterns, Physicians'/statistics & numerical data ; Protein Kinase Inhibitors/therapeutic use ; Quinolines/therapeutic use ; Retrospective Studies ; Sorafenib/therapeutic use ; Sunitinib/therapeutic use ; Thyroid Neoplasms/drug therapy ; Thyroid Neoplasms/epidemiology ; United States/epidemiology
Chemical Substances	Phenylurea Compounds ; Protein Kinase Inhibitors ; Quinolines ; Sorafenib (9ZOQ3TZI87) ; lenvatinib (EE083865G2) ; Sunitinib (V99T50803M)
Language	English
Publishing date	2019-02-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-019-0890-6
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Article: A retrospective analysis of delays in the diagnosis of lung cancer and associated costs.

Gildea, Thomas R / DaCosta Byfield, Stacey / Hogarth, D Kyle / Wilson, David S / Quinn, Curtis C

ClinicoEconomics and outcomes research : CEOR

2017 Volume 9, Page(s) 261–269

Abstract: Purpose: Diagnosis of lung cancer at advanced stages can result in missed treatment opportunities, worse outcomes, and higher health care costs. This study evaluated the wait time to diagnose non-small-cell lung cancer (NSCLC) and the cost of diagnosis ... ...

Abstract	Purpose: Diagnosis of lung cancer at advanced stages can result in missed treatment opportunities, worse outcomes, and higher health care costs. This study evaluated the wait time to diagnose non-small-cell lung cancer (NSCLC) and the cost of diagnosis and treatment based on the stage at diagnosis. Patients and methods: Adult patients diagnosed with NSCLC between January 2007 and September 2011 were identified from a proprietary oncology registry and linked to health insurance claims from a large US health insurance company. Continuous enrollment in the health plan was required for at least 12 months prediagnosis (baseline) and at least 3 months postdiagnosis (follow-up). Use of diagnostic tests and time to diagnosis were examined. The rates of health care utilization and per-patient per-month (PPPM) health care costs were calculated. Results: A total of 1,210 patients with NSCLC were included in the analysis. Most patients (93.6%) had evidence of diagnostic tests beginning 5 to 6 months prior to diagnosis, and most were diagnosed at an advanced stage (23% Stage IIIb and 46% Stage IV). The PPPM total health care costs in USD pre- and postdiagnosis were $2,407±$3,364 (mean±standard deviation) and $16,577±$33,550, respectively. PPPM total health care costs and utilization after lung cancer diagnosis were significantly higher among patients diagnosed at Stage IV disease and lowest among patients diagnosed at Stage I disease ($7,239 Stage I, $9,484 Stage II, $11,193 Stage IIIa, $17,415 Stage IIIb, and $21,441 Stage IV). Conclusion: This study showed that most patients experienced long periods of delay between their first diagnostic test for lung cancer and a definitive diagnosis, and the majority were diagnosed at advanced stages of disease. Costs associated with the management of lung cancer increased substantially with higher stages at diagnosis. Procedures that diagnose lung cancer at earlier stages may allow for less resource use and costs among patients with lung cancer.
Keywords	covid19
Language	English
Publishing date	2017-05-12
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2520698-9
ISSN	1178-6981
ISSN	1178-6981
DOI	10.2147/CEOR.S132259
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Article ; Online: ReCAP: Treatment Patterns and Cost of Care Associated With Initial Therapy Among Patients Diagnosed With Operable Early-Stage Human Epidermal Growth Factor Receptor 2-Overexpressed Breast Cancer in the United States: A Real-World Retrospective Study.

DaCosta Byfield, Stacey / Buck, Philip O / Blauer-Peterson, Cori / Poston, Sara A / DaCosta Byfield, Stacey

Journal of oncology practice

2016 Volume 12, Issue 2, Page(s) 159–167

Abstract: Purpose: Overexpression of the human epidermal growth factor receptor 2 (HER2) protein negatively affects survival in breast cancer. This study aimed to assess real-world treatment patterns and costs associated with resected nonmetastatic HER2-positive ... ...

Abstract	Purpose: Overexpression of the human epidermal growth factor receptor 2 (HER2) protein negatively affects survival in breast cancer. This study aimed to assess real-world treatment patterns and costs associated with resected nonmetastatic HER2-positive breast cancer in the United States. Patients and methods: Commercially insured patients with HER2-positive breast cancer were identified from oncology registry data linked to a large US commercial administrative claims database. Treatment patterns and health care use and costs in the initial phase of care were examined. Results: Among the 915 patients who met the study criteria, 662 (72%) were hormone receptor (HR) positive, and 253 (28%) were HR negative. Overall, 72% (n = 662) of patients received HER2-targeted therapy (HR positive, 69% v HR negative, 80%; P < .01), specifically trastuzumab. The most common treatment regimens, regardless of HR status, were carboplatin, docetaxel, and trastuzumab (47% of patients) during neoadjuvant therapy and carboplatin, docetaxel, and trastuzumab ± hormone therapy (30% of patients) during adjuvant therapy. Overall unadjusted cost of treatment per patient per month (HR positive, $11,906 v HR negative, $14,367; P < .001) was mainly cancer related (HR positive, $10,513 v HR negative, $13,073; P < .001). Adjusted 12-month cost was $176,779 (HR positive, $167,088 v HR negative, $180,226; P > .05). Conclusion: Although trastuzumab-based therapy is considered standard of care among patients with HER2-positive early-stage breast cancer, approximately 28% of these patients did not receive HER2-targeted therapy. Additional studies are warranted to examine whether patients who have not received targeted therapy are eligible for and would benefit from an HER2-targeted approach.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; Breast Neoplasms/diagnosis ; Breast Neoplasms/epidemiology ; Breast Neoplasms/etiology ; Breast Neoplasms/therapy ; Combined Modality Therapy ; Databases, Factual ; Female ; Gene Expression ; Health Care Costs ; Humans ; Middle Aged ; Neoplasm Staging ; Practice Patterns, Physicians' ; Receptor, ErbB-2/genetics ; Retrospective Studies ; Time Factors ; United States/epidemiology
Chemical Substances	Biomarkers, Tumor ; Receptor, ErbB-2 (EC 2.7.10.1)
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2236338-5
ISSN	1935-469X ; 1554-7477
ISSN (online)	1935-469X
ISSN	1554-7477
DOI	10.1200/JOP.2015.004747
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