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Unmet need for previously untreated metastatic triple-negative breast cancer: a real-world study of patients diagnosed from 2011 to 2022 in the United States.

Unmet need for previously untreated metastatic triple-negative breast cancer: a real-world study of patients diagnosed from 2011 to 2022 in the United States. The oncologist Punie, K., Kurian, A. W., Ntalla, I., Sjekloca, N., Estrin, A., Dabrowski, E. C., Lai, C., Hurvitz, S. 2025; 30 (3)

Abstract

This real-world study describes the treatment landscape evolution after targeted therapy approval and associated survival outcomes for previously untreated metastatic triple-negative breast cancer (mTNBC) in the United States.This retrospective analysis used de-identified electronic health record-derived data of patients diagnosed with mTNBC (January 2011-July 2022; index date was first-line [1L] treatment start date). Patient characteristics, treatment patterns, real-world overall survival (rwOS), and time to next treatment or death (TTNTD) were determined. Outcomes before (2011-2017, early cohort) and after (2018-2022, late cohort) targeted therapy approval were evaluated.Among 2004 eligible patients, 21% were classified as Black, 13% had Eastern Cooperative Oncology Group performance status =2, and 63% were diagnosed with recurrent disease; median age was 60 years. First-line chemotherapy-only (single- and multiple-agent chemotherapy) use decreased with the introduction of targeted therapies from 96% before 2018 to 65% between 2019 and 2022. From 2019, 33% of patients received programmed death-(ligand) 1 inhibitor-based regimen; ~2% received poly (ADP-ribose) polymerase inhibitors. Median 1L treatment duration was 2.6 months and this did not change over time. Of all 1L patients, 34% died before second-line (2L) and 51% subsequently received 2L treatment. Median (95% CI) 1L rwOS and TTNTD were 11.3 (10.7-12.0) months and 4.3 (4.1-4.6) months, respectively. Median 1L 5-year survival [95% CI] showed statistically significant but small improvement from the early (10.9 [10.3-11.6] months) to late cohort (11.9 [10.7-13.1] months; HR [95% CI], 0.87 [0.78-0.96]).This analysis demonstrated that, despite changes in care over time, survival improvements were not clinically meaningful; thus, a substantial unmet need for more efficacious treatments in previously untreated patients with mTNBC remains.

View details for DOI 10.1093/oncolo/oyaf034

View details for PubMedID 40163689