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Real-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer : a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institution

datacite.subject.fosCiências Médicas::Ciências da Saúde
datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorTeodoro, Maria Inês
dc.contributor.authorMayer, Alexandra
dc.contributor.authorMiranda, Ana da Costa
dc.contributor.authorNunes, Hugo
dc.contributor.authorCosta, Filipa Alves da
dc.contributor.authorLourenço, António
dc.date.accessioned2026-04-16T15:02:18Z
dc.date.available2026-04-16T15:02:18Z
dc.date.issued2024-01
dc.description.abstractBackground: Monotherapy with aromatase inhibitors and fulvestrant were the standard-of-care for hormone receptor-positive (HR+)/human epidermal growth factor receptor-type2 negative (HER2-) advanced breast cancer, before integration of cyclin-dependent kinase 4/6 inhibitors. Effectiveness data is essential for regulatory action, but little is known about real-world use of aromatase inhibitors and fulvestrant. Methods: A retrospective cohort study was conducted resorting to data from a cancer registry to identify adult women with HR+/HER2- advanced breast cancer exposed to aromatase inhibitors or fulvestrant (31 May 2017–31 March 2019) at the main oncology hospital in Portugal. Cases were updated with follow-up until death or cut-off (31 March 2021) and pseudoanonymized data extracted. Primary outcome was overall survival (OS) and secondary time to treatment failure (TTF), estimated using survival analysis and compared with published trials. Results: 192 patients were distributed by subgroups according to the medicine. Letrozole: OS 30.8 (95% confidence interval (CI) 20.6–41.4); TTF 11.2 (95%CI 8.7–13.7). Exemestane: OS 22.1 (95%CI 9.7–34.6); TTF 6.0 (95%CI 4.1–7.8). Fulvestrant: OS 21.6 (95%CI 16.5–26.7); TTF 5.6 (95%CI 4.5–6.6). Conclusions: Estimated effectiveness (OS) of letrozole and fulvestrant was, respectively, 3.2–3.5 months lower than reported. The clinical meaning seems uncertain and may be explained by a higher proportion of worse prognostic characteristics in patients treated in the real-world.eng
dc.identifier.citationTeodoro, M. I., Mayer, A., da Costa Miranda, A., Nunes, H., da Costa, F. A., & Lourenço, A. (2024). Real-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer: a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institution. Journal of Pharmaceutical Policy and Practice, 17(1). https://doi.org/10.1080/20523211.2023.2296551
dc.identifier.doi10.1080/20523211.2023.2296551
dc.identifier.issn2052-3211
dc.identifier.urihttp://hdl.handle.net/10400.26/62723
dc.language.isoeng
dc.peerreviewedyes
dc.publisherTaylor and Francis
dc.relation.hasversionhttps://doi.org/10.1080/20523211.2023.2296551
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAdvanced breast cancer
dc.subjectRegistries
dc.subjectEffectiveness
dc.subjectFulvestrant
dc.subjectAromatase inhibitors
dc.subjectPharmacoepidemiology
dc.titleReal-world effectiveness of aromatase inhibitors and fulvestrant in HR+/HER2- advanced breast cancer : a snapshot of the last two years before conventional use of CDK 4/6 inhibitors in a Portuguese institutioneng
dc.typecontribution to journal
dspace.entity.typePublication
oaire.citation.issue1
oaire.citation.startPage2296551
oaire.citation.titleJournal of Pharmaceutical Policy and Practice
oaire.citation.volume17
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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