Real-world treatment outcomes of abemaciclib in older patients with HR+, HER2- metastatic breast cancer in Japan

To understand the real-world use of abemaciclib in older patients (≥65 years) with HR+, HER2− metastatic breast cancer (MBC) in Japan.
This study retrospectively analyzed a Japanese administrative claims database for patients with HR+, HER2− MBC who received abemaciclib as the first CDK4/6 inhibitor (CDK4/6i) from November 2018 to May 2023. Patient characteristics and treatment patterns were summarized. Median time to discontinuation (mTTD) and chemotherapy-free survival (CSF) was estimated using Kaplan – Meier method.
Among 3,699 abemaciclib-treated patients with HR+, HER2− MBC, 1,681 (45.4%) were ≥65 years old. Among these, abemaciclib + fulvestrant (55.0%) was the most common regimen. The mTTD (95% CI) of first abemaciclib therapy was 12.8 months (11.4–13.6). The overall mTTD (95% CI) with all the BC drugs after starting abemaciclib was 40.2 months (37.0–44.0). The median (95% CI) CFS after starting abemaciclib was 34.8 months (30.2–39.5). Among 1,149 older patients who discontinued the abemaciclib therapy, 897 (78.1%) patients received subsequent treatment. The most common first subsequent therapy was the endocrine therapy + CDK4/6i regimen (34.9%).
This study indicated that abemaciclib regimens were feasible for older patients with HR+, HER2− MBC in Japan.
Abemaciclib is prescribed for the treatment of early or metastatic breast cancer in Japan. We used a big database from Japan that has anonymized information for about 46.3 million patients from 500 hospitals. We described the patient characteristics and drug treatments among older patients (≥65 years old) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2 negative (HER2−) metastatic breast cancer who were treated with abemaciclib in Japan. We included 3,699 patients with HR+, HER2− metastatic breast cancer who were treated with abemaciclib. Among these, 45.4% were older patients with a median age of 72 years. Abemaciclib + fulvestrant (55.0%) was the most commonly prescribed regimen in older patients. The median time to discontinuation for first abemaciclib treatment was 12.8 months in older patients. Among 1,149 older patients who discontinued the abemaciclib therapy, 78.1% of patients received subsequent treatment. The most common subsequent therapy was endocrine therapy + CDK4/6 inhibitors (34.9%). Our study indicated that abemaciclib regimens were feasible for older patients with HR+, HER2− metastatic breast cancer in Japan.