Evidence map›Paper›PMID 39427280›Full record

Observational studyBreast cancer research and treatment2025

Attrition between lines of therapy and real-world outcomes of patients with HER2-positive metastatic breast cancer in Europe: a cohort study leveraging electronic medical records.

Paul Cottu, Sue Cheeseman, Peter Hall, Achim Wöckel, Christian W Scholz, Emilio Bria, Armando Orlandi, Nuria Ribelles, Mahéva Vallet, Nicolas Niklas and 7 more

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Paul CottuDepartment of Medical Oncology, Institut Curie, Université Paris Cité, Paris, France. paul.cottu@curie.fr.
Sue CheesemanLeeds Teaching Hospitals NHS Trust, Leeds, UK.
Peter HallUniversity of Edinburgh, Edinburgh, UK.
Achim WöckelDepartment of Gynecology, University Hospital Würzburg, Würzburg, Germany.
Christian W ScholzDepartment of Hematology and Oncology, Vivantes Klinikum Am Urban, Berlin, Germany.
Emilio BriaUnit of Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Armando OrlandiUnit of Oncology, Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Nuria RibellesDepartment of Medical Oncology, Hospital Universitario Virgen de La Victoria, IBIMA, Málaga, Spain.
Mahéva ValletUniversity of Edinburgh, Edinburgh, UK.
Nicolas NiklasIQVIA, Frankfurt, Germany.
Catherine HoggIQVIA, London, UK.
Shivani AggarwalLandmark Science, Los Angeles, CA, USA.
Joana MoreiraIQVIA, Lisbon, Portugal.
Markus LucernaDaiichi Sankyo Europe GmbH, Munich, Germany.
Simon M CollinOncology Outcomes Research, Global Medical Affairs, Oncology Business Unit, AstraZeneca, Cambridge, UK.
Amanda LogueMedical Communications and Information, Global Medical Affairs, Oncology Business Unit, AstraZeneca, Cambridge, UK.
Gráinne H LongOncology Outcomes Research, Global Medical Affairs, Oncology Business Unit, AstraZeneca, Cambridge, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo characterize real-world attrition rates across first-line (1L) to third-line (3L) therapies in patients with HER2-positive (HER2 +) metastatic breast cancer (mBC) receiving routine care in seven hospital systems across Europe (France, Germany, Italy, Spain, and the UK).

methodsThis retrospective, observational, multi-country, cohort study collected electronic medical record data from women aged ≥ 18 years diagnosed with HER2 + mBC from 2017-2021. The primary endpoint was attrition rate (the proportion of patients receiving a line of therapy [LOT] with no further evidence of subsequent LOTs). Key additional endpoints included treatment patterns, real-world time to treatment discontinuation (TTD), and time to next treatment (TTNT).

results29.6% (95% confidence interval [CI] 25.0-34.6) and 34.2% (95% CI 27.5-41.5) of treated patients with HER2 + mBC had no further evidence of treatment beyond 1L and second-line (2L) therapy, respectively. Attrition was primarily owing to death, move to end-of-life palliative care, loss to follow up, and "other" reasons. Treatment patterns were generally aligned with clinical guidelines. Decreases in TTD (12.1 months [95% CI 10.4-14.5] for 1L, 8.9 months [95% CI 7.3-11.9] for 2L, 6.4 months [95% CI 5.2-8.9] for 3L) and TTNT (15.4 months [95% CI 13.6-20.6] for 1L, 13.5 months [95% CI 10.8-19.4] for 2L) were observed with each subsequent LOT.

conclusionResults unveil a large proportion of patients who do not benefit from state-of-the-art subsequent LOT, and suggest diminishing effectiveness with each subsequent LOT.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsElectronic Health RecordsErb-b2 Receptor Tyrosine KinasesAdultAgedAged, 80 and overCohort StudiesEuropeFemaleHumansMiddle AgedNeoplasm MetastasisRetrospective StudiesTreatment OutcomeERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesAttritionBreast neoplasmERBB2 proteinHER2Neoplasm metastasisReal-world data

Identifiers

PMID39427280
PMCPMC11785661

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.