Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database
Background: Our objective was to describe the hospital-based systemic treatment sequences in early stage HER2+ breast cancer patients treated with trastuzumab in France in 2016. Methods: This retrospective observational study was based on the national hospital discharge database (PMSI). Patients hos...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Cancer Informatics |
| Online Access: | https://doi.org/10.1177/11769351221135134 |
| _version_ | 1811233519475621888 |
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| author | Olivier Tredan Marie Laurent Melina Gilberg Rim Ghorbal Alexandre Vainchtock Joannie Lortet-Tieulent Martin Prodel Julien Dupin |
| author_facet | Olivier Tredan Marie Laurent Melina Gilberg Rim Ghorbal Alexandre Vainchtock Joannie Lortet-Tieulent Martin Prodel Julien Dupin |
| author_sort | Olivier Tredan |
| collection | DOAJ |
| description | Background: Our objective was to describe the hospital-based systemic treatment sequences in early stage HER2+ breast cancer patients treated with trastuzumab in France in 2016. Methods: This retrospective observational study was based on the national hospital discharge database (PMSI). Patients hospitalized for breast cancer in 2016 and administration of trastuzumab between 6 months prior and 1 year after surgery were included. The following treatments were identified: (1) trastuzumab ± chemotherapy; (2) chemotherapy alone; (3) q3w trastuzumab weekly chemotherapy. Hospital admissions for cardiac events before and after the surgery were investigated. An unsupervised machine learning technic called TAK (Time-sequence Analysis through K-clustering) was used to identify and visualize typical systemic treatment sequences. Results: Overall, 3531 patients were included: 2619 adjuvant cohort patients (74.2%) and 912 neoadjuvant cohort patients (25.8%). The mean age was 56.4 years (±12.3), 99.7% patients were female. Treatment initiation occurred within 6 weeks of the surgery in 58% and 92% of patients, and trastuzumab treatment lasted 12 months (±1 month) in 75% and 66% of patients in the adjuvant and neoadjuvant cohorts, respectively. Nevertheless, 12% and 22% of patients were treated with trastuzumab for <11 months in the adjuvant and neoadjuvant cohorts, respectively. There was not one standard sequence of treatments per cohort, but 4 and 3 typical treatment sequences in the adjuvant and the neoadjuvant cohorts, respectively, plus 2 treatment sequences with an early treatment withdrawal. The frequency of patients with ⩾1 hospital stay with a cardiac event was higher among patients with an early treatment withdrawal. Conclusions: The treatment sequences of most patients were in line with the recommendations in force. The machine learning approach provided a telling visual display of the results, thereby allowing healthcare professionals, health authorities, patients, and care givers to see the whole picture of the hospital-administered drug strategies. |
| first_indexed | 2024-04-12T11:21:22Z |
| format | Article |
| id | doaj.art-c1f925f71c69460eade9744700a46d60 |
| institution | Directory Open Access Journal |
| issn | 1176-9351 |
| language | English |
| last_indexed | 2024-04-12T11:21:22Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Cancer Informatics |
| spelling | doaj.art-c1f925f71c69460eade9744700a46d602022-12-22T03:35:21ZengSAGE PublishingCancer Informatics1176-93512022-11-012110.1177/11769351221135134Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital DatabaseOlivier Tredan0Marie Laurent1Melina Gilberg2Rim Ghorbal3Alexandre Vainchtock4Joannie Lortet-Tieulent5Martin Prodel6Julien Dupin7Medical Oncology Department, Centre Léon Bérard, Lyon, FranceHEVA, Lyon Cedex, FranceRoche S.A.S. Medical Affairs France, Boulogne-Billancourt Cedex, FranceRoche S.A.S. Medical Affairs France, Boulogne-Billancourt Cedex, FranceHEVA, Lyon Cedex, FranceHEVA, Lyon Cedex, FranceHEVA, Lyon Cedex, FranceRoche S.A.S. Medical Affairs France, Boulogne-Billancourt Cedex, FranceBackground: Our objective was to describe the hospital-based systemic treatment sequences in early stage HER2+ breast cancer patients treated with trastuzumab in France in 2016. Methods: This retrospective observational study was based on the national hospital discharge database (PMSI). Patients hospitalized for breast cancer in 2016 and administration of trastuzumab between 6 months prior and 1 year after surgery were included. The following treatments were identified: (1) trastuzumab ± chemotherapy; (2) chemotherapy alone; (3) q3w trastuzumab weekly chemotherapy. Hospital admissions for cardiac events before and after the surgery were investigated. An unsupervised machine learning technic called TAK (Time-sequence Analysis through K-clustering) was used to identify and visualize typical systemic treatment sequences. Results: Overall, 3531 patients were included: 2619 adjuvant cohort patients (74.2%) and 912 neoadjuvant cohort patients (25.8%). The mean age was 56.4 years (±12.3), 99.7% patients were female. Treatment initiation occurred within 6 weeks of the surgery in 58% and 92% of patients, and trastuzumab treatment lasted 12 months (±1 month) in 75% and 66% of patients in the adjuvant and neoadjuvant cohorts, respectively. Nevertheless, 12% and 22% of patients were treated with trastuzumab for <11 months in the adjuvant and neoadjuvant cohorts, respectively. There was not one standard sequence of treatments per cohort, but 4 and 3 typical treatment sequences in the adjuvant and the neoadjuvant cohorts, respectively, plus 2 treatment sequences with an early treatment withdrawal. The frequency of patients with ⩾1 hospital stay with a cardiac event was higher among patients with an early treatment withdrawal. Conclusions: The treatment sequences of most patients were in line with the recommendations in force. The machine learning approach provided a telling visual display of the results, thereby allowing healthcare professionals, health authorities, patients, and care givers to see the whole picture of the hospital-administered drug strategies.https://doi.org/10.1177/11769351221135134 |
| spellingShingle | Olivier Tredan Marie Laurent Melina Gilberg Rim Ghorbal Alexandre Vainchtock Joannie Lortet-Tieulent Martin Prodel Julien Dupin Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database Cancer Informatics |
| title | Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database |
| title_full | Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database |
| title_fullStr | Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database |
| title_full_unstemmed | Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database |
| title_short | Innovative Approach for a Typology of Treatment Sequences in Early Stage HER2 Positive Breast Cancer Patients Treated With Trastuzumab in the French National Hospital Database |
| title_sort | innovative approach for a typology of treatment sequences in early stage her2 positive breast cancer patients treated with trastuzumab in the french national hospital database |
| url | https://doi.org/10.1177/11769351221135134 |
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