The unmet need of HR+ breast cancer (BC)
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The unmet need of HR+ breast cancer (BC) Epidemiology Disease biology and treatment Caring for someone with BC has a significant impact on financial, work, and emotional status 8,9 BC is now the most common type of cancer in the world 1 • Hormone receptor-positive (HR+) BC is the most common subtype, representing ~70% of cases 3 Breast cancer accounts for ~12% of the overall cost of cancer treatment annually in the EU 10 Devastating impacts of HR+ BC are extensive for both the patient and their wider community: • Hundreds of thousands of women (and a small number of men) affected by this subtype each year, with huge societal impact worldwide 1,4 • Side effects can be all-consuming, affecting quality of life (QoL), appearance and even fertility 5,6 • Long, emotional, and exhausting journey due to the duration of treatment, risk of recurrence and the impact on QoL 4,5,7 12% 2.3M 1.6M 1980 2010 Today Yearly cases 1,2 640K HR+ tumour cells produce abnormal amounts of receptors for the hormones oestrogen and/or progesterone 11 Oestrogen encourages HR+ BC cells to divide by activating the receptors, ultimately leading to tumour growth. Different medicines work by blocking this receptor to prevent the action of oestrogen 11 For patients diagnosed with HR+ early BC: • Side-effects can be gruelling, with up to 10 years of treatment often being required 5,12 ~50% stop treatment prematurely, many because of these side-effects 12 Resistance to treatment remains a major challenge 4 HR+ Metastatic BC (mBC) is a key barrier to overcome Whilst progress has been made and therapies are available for HR+ BC, more effective and tolerable treatments are needed to help patients live longer and live better. 13 Patient testimonial I had muscle pain, joint pain - now that I stopped the treatment the side effects got even worse - I didn't know that and no one told me – Yvonne Ulrich, Patient, Switzerland At Roche, we are striving to help make the treatment of HR+ BC more tailored, more effective and less debilitating in order to reduce the burden of treatment so that patients can have a better QoL. References 30% of HR+ BC patients develop metastatic (incurable) disease at some point 14 The goal of treatment is to prolong life, whilst limiting the impact of side effects on patients’ QoL While survival for mBC has improved, patients eventually require chemotherapy, meaning additional side effects More advances are required to delay disease progression, and the need for chemotherapy, and enable patients to continue their day-to-day lives for longer 15 mBC patients have multiple and varied concerns related to their disease including: Therapy-related side effects 5 Financial strain on patients and caregivers 8,16 Disruption of daily activities 17 Cancer spread/ progression 17,18 Loneliness 17 Mobility 17 1. Sung H, et al. Global cancer statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;0:1. 2. Forouzanfar MH et al. Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. The Lancet. 2011; 378(9801):1461-84. 3. Lim, et al. The natural history of hormone receptor positive breast cancer. Oncology (Williston Park). 2012;8:688-94, 696. 4. Tomas R and Barrios C. Optimal management of hormone receptor positive metastatic breast cancer in 2016. Ther Adv Med Oncol. 2015;7:304-20. 5. Galipeau N, et al. Understanding key symptoms, side effects, and impacts of HR+/HER2- advanced breast cancer: qualitative study findings. J Patient-Rep Outcomes. 2019;3:10-22. 6. Buonomoa B and Peccatori F. Fertility preservation in endocrine responsive breast cancer: data and prejudices. ecancer 2020;14:1157. 7. American Cancer Society. Hormone therapy for breast cancer. [Internet; cited September 2021]. Available from: https://www.cancer.org/cancer/breast-cancer/ treatment/hormone-therapy-for-breast-cancer.html. 8. Kusi G et al. The experiences of family caregivers living with breast cancer patients in low-and middle-income countries: a systematic review. Systematic Reviews 2020;9:165. 9. Lambert-Obry V et al. Real-world patient- and caregiver reported outcomes in advanced breast cancer. Curr Oncol. 2018; 25(4): e282–e290. 10. Luengo-Fernandez R et al. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet Oncol. 2013;14(12):1165-74. 11. Cancer.org. Breast cancer hormone receptor status [Internet; cited September 2021]. Available from: https:// www.cancer.org/cancer/breast-cancer/understanding- a-breast-cancer-diagnosis/breast-cancer-hormone- receptor-status.html. 12. Finitsis D, et al. Interventions to promote adherence to endocrine therapy among breast cancer survivors: A meta-analysis. Psycho-Oncology 2019;28:255-63. 13. Kay, C., et al. Current trends in the treatment of HR+/HER2+ breast cancer. Future Oncology, 2021;17;13;1665-81. 14. Scharl A, et al. The Right Treatment for the Right Patient – Personalised Treatment of Breast Cancer. Geburtshilfe Frauenheilkd. 2015;75(7)683-91. 15. Brufsky A. Delaying Chemotherapy in the Treatment of Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer. Oncology 2015;9:137-47 16. Fenn KM, Evans SB, McCorkle R, DiGiovanna MP , Pusztai L, Sanft T, et al. Impact of financial burden of cancer on survivors’ quality of life. J Oncol Pract. 2014;10(5):332-8. 17. Mosher CE, Johnson C, Dickler M, Norton L, Massie MJ, DuHamel K. Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae. Breast J. 2013;19(3):285-92. 18. McClelland SI, Holland KJ, Griggs JJ. Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis. Qual Life Res. 2015;24(12):2939-43.
Transcript of The unmet need of HR+ breast cancer (BC)
The unmet need of HR+ breast cancer (BC)Epidemiology
Disease biology and treatment
Caring for someone with BC has a significant impact on financial, work, and emotional status8,9
BC is now the most common type of cancer in the world1
• Hormone receptor-positive (HR+) BC is the most common subtype, representing ~70% of cases3
Breast cancer accounts for ~12% of the overall cost of cancer treatment annually in the EU10
Devastating impactsof HR+ BC areextensive for boththe patient and their wider community:• Hundreds of thousands of women (and a small
number of men) affected by this subtype each year, with huge societal impact worldwide1,4
• Side effects can be all-consuming, affecting quality of life (QoL), appearance andeven fertility5,6
• Long, emotional, and exhausting journey due to the duration of treatment, risk of recurrence and the impact on QoL4,5,7
12%
2.3M
1.6M
19802010
TodayYearly cases1,2
640K
HR+ tumour cells produce abnormal amountsof receptors for thehormones oestrogen and/or progesterone11
Oestrogen encourages HR+ BC cells to divide by activating the receptors, ultimately leading to tumour growth. Different medicines work by blocking this receptor to prevent the action of oestrogen11
For patients diagnosed with HR+ early BC:
• Side-effects can be gruelling, with up to 10 years of treatment often being required5,12
~50% stop treatment prematurely,many because of these side-effects12
Resistance to treatmentremains a major challenge4
HR+
Metastatic BC (mBC) is a key barrierto overcome
Whilst progress has been made and therapies are availablefor HR+ BC, more effective and tolerable treatments
are needed to help patients live longer and live better.13
Patient testimonial
I had muscle pain, joint pain- now that I stopped the treatment the side effects got even worse - I didn't know that and no one told me – Yvonne Ulrich, Patient, Switzerland
At Roche, we are striving to help make the treatment of HR+ BCmore tailored, more effective andless debilitating in order to reduce the burden of treatment so that patients can have a better QoL.
References
30% of HR+ BC patients develop metastatic (incurable) disease at some point14
The goal of treatment is to prolong life, whilst limiting the impact of side effects on patients’ QoL
While survival for mBC has improved, patients eventually require chemotherapy, meaning additional side effects
More advances are required to delay disease progression, and the need for chemotherapy, and enable patients to continue their day-to-day lives for longer15
mBC patients have multiple and varied concerns related to theirdisease including:
Therapy-relatedside effects5
Financial strainon patients and
caregivers8,16
Disruption ofdaily activities17
Cancer spread/progression17,18
Loneliness17
Mobility17
1. Sung H, et al. Global cancer statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;0:1.
2. Forouzanfar MH et al. Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis. The Lancet. 2011; 378(9801):1461-84.
3. Lim, et al. The natural history of hormone receptor positive breast cancer. Oncology (Williston Park). 2012;8:688-94, 696.
4. Tomas R and Barrios C. Optimal management of hormone receptor positive metastatic breast cancer in 2016. Ther Adv Med Oncol. 2015;7:304-20.
5. Galipeau N, et al. Understanding key symptoms, side effects, and impacts of HR+/HER2- advanced breast cancer: qualitative study findings. J Patient-Rep Outcomes. 2019;3:10-22.
6. Buonomoa B and Peccatori F. Fertility preservation in endocrine responsive breast cancer: data and prejudices. ecancer 2020;14:1157.
7. American Cancer Society. Hormone therapy for breast cancer. [Internet; cited September 2021]. Available from: https://www.cancer.org/cancer/breast-cancer/treatment/hormone-therapy-for-breast-cancer.html.
8. Kusi G et al. The experiences of family caregivers living with breast cancer patients in low-and middle-income countries: a systematic review. Systematic Reviews 2020;9:165.
9. Lambert-Obry V et al. Real-world patient- and caregiver reported outcomes in advanced breast cancer. Curr Oncol. 2018; 25(4): e282–e290.
10. Luengo-Fernandez R et al. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet Oncol. 2013;14(12):1165-74.
11. Cancer.org. Breast cancer hormone receptor status [Internet; cited September 2021]. Available from: https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-hormone-receptor-status.html.
12. Finitsis D, et al. Interventions to promote adherence to endocrine therapy among breast cancer survivors: A meta-analysis. Psycho-Oncology 2019;28:255-63.
13. Kay, C., et al. Current trends in the treatment of HR+/HER2+ breast cancer. Future Oncology, 2021;17;13;1665-81.
14. Scharl A, et al. The Right Treatment for the Right Patient – Personalised Treatment of Breast Cancer. Geburtshilfe Frauenheilkd. 2015;75(7)683-91.
15. Brufsky A. Delaying Chemotherapy in the Treatment of Hormone Receptor-Positive, Human Epidermal Growth Factor Receptor 2-Negative Advanced Breast Cancer. Oncology 2015;9:137-47
16. Fenn KM, Evans SB, McCorkle R, DiGiovanna MP, Pusztai L, Sanft T, et al. Impact of financial burden of cancer on survivors’ quality of life. J Oncol Pract. 2014;10(5):332-8.
17. Mosher CE, Johnson C, Dickler M, Norton L, Massie MJ, DuHamel K. Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae. Breast J. 2013;19(3):285-92.
18. McClelland SI, Holland KJ, Griggs JJ. Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis. Qual Life Res. 2015;24(12):2939-43.
