Impact of demographics on CDK4/6 inhibitor outcomes in metastatic breast cancer
Location
Philadelphia, PA
Start Date
30-4-2025 1:00 PM
End Date
30-4-2025 4:00 PM
Description
Background
Cyclin-dependent kinase 4 and 6 inhibitors (CDKis) are the standard first-line therapy for patients with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). However, these medications can be expensive, potentially limiting access and affecting patient outcomes. Breast cancer prognosis varies significantly by race, socioeconomic status, and other demographic factors, yet the specific impact of CDKi access in these populations remains underexplored. Understanding disparities in CDKi accessibility and outcomes is crucial to addressing potential inequities in MBC treatment.
Research Design and Methods
In this retrospective review, data was collected from patients with ER+ MBC who were prescribed first-line CDKi therapy at a large NCI-designated cancer center from January 2015 through December 2022. Data abstraction included time from CDKi prescription to drug initiation (TTI), time from CDKi initiation to progression of disease (TTP), and time from CDKi initiation to death or June 30, 2022. Additional variables included age, race, partner status, insurance type, body mass index (BMI), and number of comorbidities. Descriptive, comparative, and correlational statistics were used, including Kaplan-Meier survival analysis. Multivariate logistic regression was performed to analyze independent predictors of outcomes.
Results
The analysis was conducted from July 2022 to May 2023 and included 173 patients. There were no significant differences in time to initiation (TTI) or time to progression (TTP) of CDKi therapy based on age, race, or other demographic variables. A trend toward shorter overall survival was observed in patients with Medicaid insurance compared to those with Medicare; however, this was not statistically significant (Hazard Ratio [HR] = 0.54, p = 0.063, 95% CI = 0.28–1.03). In the multivariate model assessing TTI to death, patients with Medicaid insurance had significantly shorter overall survival than those with private insurance (HR = 0.37, p = 0.013, 95% CI = 0.16–0.81).
Conclusions
Medicaid insurance is associated with worse MBC therapy outcomes independent of TTI delay. While the specific relationship between insurance status and CDKi outcomes remains unclear, this finding suggests broader disparities in cancer care access and treatment continuity. Future research should explore structural barriers and potential interventions, such as treatment personalization and improved healthcare navigation, to mitigate these disparities.
Embargo Period
5-19-2025
Impact of demographics on CDK4/6 inhibitor outcomes in metastatic breast cancer
Philadelphia, PA
Background
Cyclin-dependent kinase 4 and 6 inhibitors (CDKis) are the standard first-line therapy for patients with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). However, these medications can be expensive, potentially limiting access and affecting patient outcomes. Breast cancer prognosis varies significantly by race, socioeconomic status, and other demographic factors, yet the specific impact of CDKi access in these populations remains underexplored. Understanding disparities in CDKi accessibility and outcomes is crucial to addressing potential inequities in MBC treatment.
Research Design and Methods
In this retrospective review, data was collected from patients with ER+ MBC who were prescribed first-line CDKi therapy at a large NCI-designated cancer center from January 2015 through December 2022. Data abstraction included time from CDKi prescription to drug initiation (TTI), time from CDKi initiation to progression of disease (TTP), and time from CDKi initiation to death or June 30, 2022. Additional variables included age, race, partner status, insurance type, body mass index (BMI), and number of comorbidities. Descriptive, comparative, and correlational statistics were used, including Kaplan-Meier survival analysis. Multivariate logistic regression was performed to analyze independent predictors of outcomes.
Results
The analysis was conducted from July 2022 to May 2023 and included 173 patients. There were no significant differences in time to initiation (TTI) or time to progression (TTP) of CDKi therapy based on age, race, or other demographic variables. A trend toward shorter overall survival was observed in patients with Medicaid insurance compared to those with Medicare; however, this was not statistically significant (Hazard Ratio [HR] = 0.54, p = 0.063, 95% CI = 0.28–1.03). In the multivariate model assessing TTI to death, patients with Medicaid insurance had significantly shorter overall survival than those with private insurance (HR = 0.37, p = 0.013, 95% CI = 0.16–0.81).
Conclusions
Medicaid insurance is associated with worse MBC therapy outcomes independent of TTI delay. While the specific relationship between insurance status and CDKi outcomes remains unclear, this finding suggests broader disparities in cancer care access and treatment continuity. Future research should explore structural barriers and potential interventions, such as treatment personalization and improved healthcare navigation, to mitigate these disparities.
Comments
Presented by Marina Petruzzi