Breast Adjuvant Chemotherapy

Patterns of Care in Patterns of Care in Medical OncologyMedical Oncology

Adjuvant Chemotherapy

In general, when using chemotherapy in the In general, when using chemotherapy in the adjuvant setting for patients with adjuvant setting for patients with smaller, smaller,

node-negativenode-negative, HER2-negative tumors,, HER2-negative tumors, what tends to be the most common what tends to be the most common

regimen you use?regimen you use?

20072006

10%8%Other

Clinical investigators (CI)

4%

6%

41%*

39%

9%CMF

7%

60%

16%

AC/taxane regimens

AC

TC

* 14% of CIs use dose-dense AC

In general, when using chemotherapy In general, when using chemotherapy in the adjuvant setting for patients with in the adjuvant setting for patients with smaller, smaller, node-negativenode-negative, HER2-negative , HER2-negative

tumors,tumors, what tends to be the most common what tends to be the most common regimen you use?regimen you use?

20072006

2%9%Other

Practicing oncologists (PO)

5%

20%

52%*

21%

4%CMF

19%

65%

3%

AC/taxane regimens

AC

TC

* 9% of POs use dose-dense AC

In general, when using chemotherapy in In general, when using chemotherapy in the adjuvant setting for patients with the adjuvant setting for patients with

node-positivenode-positive, HER2-negative tumors,, HER2-negative tumors, what tends to be the most common what tends to be the most common chemotherapy regimen you use? chemotherapy regimen you use?

20072006


17%9%Other

0%

20%

0%

63%

4%AC ➙ docetaxel q3wk

16%

0%

71%

TAC

AC ➙ paclitaxel q3wk

Dose-dense AC ➙ paclitaxel q2wk

In general, when using chemotherapy in In general, when using chemotherapy in the adjuvant setting for patients with the adjuvant setting for patients with

node-positivenode-positive, HER2-negative tumors,, HER2-negative tumors, what tends to be the most common what tends to be the most common chemotherapy regimen you use? chemotherapy regimen you use?

20072006

20%6%Other


7%

12%

7%

54%

10%AC ➙ docetaxel q3wk

13%

20%

51%

TAC

AC ➙ paclitaxel q3wk

Dose-dense AC ➙ paclitaxel q2wk

What percent of your patients with What percent of your patients with node-negativenode-negative breast cancer who breast cancer who

receive adjuvant chemotherapy receive receive adjuvant chemotherapy receive regimens that include taxanes?regimens that include taxanes?

200720062005

44%38%28%Mean



58%32% 40%Mean

* All participants other than 2 POs had heard about the study.

Where have you received information about Where have you received information about TC as reported by the US Oncology Group? TC as reported by the US Oncology Group?

(May have more than one response)*(May have more than one response)*

25%6%Reading another journal or print piece

20%

27%

73%

84%

21%Other live or enduring continuing education programs

39%

61%

18%

Listening to audio interviews or roundtable discussions in the Breast Cancer Update series

Reading the Journal of Clinical Oncology

Attending the 2005 San Antonio Breast Cancer Symposium

Clinical investigators Practicing oncologists

Have you utilized the adjuvant TC regimen?Have you utilized the adjuvant TC regimen?

20072006

55%23%Percent answering yes



76%55%Percent answering yes

How would you compare TC How would you compare TC (docetaxel/cyclophosphamide) to AC?(docetaxel/cyclophosphamide) to AC?

Antitumor efficacyAntitumor efficacy

20072006

0%0%AC is significantly more efficacious


0%

22%

62%

16%

0%AC is somewhat more efficacious

23%

66%

11%

Both are similar in efficacy

TC is somewhat more efficacious

TC is significantly more efficacious

2007 CI n = 50


Antitumor efficacyAntitumor efficacy

20072006

1%0%AC is significantly more efficacious


5%

64%

27%

3%

4%AC is somewhat more efficacious

43%

42%

11%

Both are similar in efficacy

TC is somewhat more efficacious

TC is significantly more efficacious

2007 PO n = 135

20072006

2%0%AC has significantly better safety and tolerability


10%

29%

51%

8%

19%AC has somewhat better safety and tolerability

36%

40%

5%

Both are similar in safety and tolerability

TC has somewhat better safety and tolerability

TC has significantly better safety and tolerability


Safety and tolerabilitySafety and tolerability


Safety and tolerabilitySafety and tolerability

20072006

1%1%AC has significantly better safety and tolerability


8%

32%

48%

11%

7%AC has somewhat better safety and tolerability

36%

49%

7%

Both are similar in safety and tolerability

TC has somewhat better safety and tolerability

TC has significantly better safety and tolerability

2007 PO n = 140

Have you ordered the OncoHave you ordered the Oncotypetype DX™ assay? DX™ assay?

200720062005

75%48%34%Percent answering yes



98%80% 96%Percent answering yes

If yes, for how many patients?200720062005

14105Mean



278 15Mean

When the OncoWhen the Oncotypetype DX assay is DX assay is requested for your patients, who requested for your patients, who

generally initiates the order?generally initiates the order?

4%

4%

92%

6%

4%

90%

Other/do not use

Surgeon

Medical oncologist


If you had breast cancer and were If you had breast cancer and were diagnosed with a 2-cm, ER-positive, diagnosed with a 2-cm, ER-positive,

node-negative tumor with an Onconode-negative tumor with an Oncotypetype DX DX recurrence score in the intermediate range, recurrence score in the intermediate range, how comfortable would you be participating how comfortable would you be participating in the TAILORx study, in which you would in the TAILORx study, in which you would

be randomly assigned to hormonal therapy be randomly assigned to hormonal therapy with or without chemotherapy?with or without chemotherapy?

12%10%Very uncomfortable

19%12%Somewhat uncomfortable

6%

24%

48%

18%

30%

21%

Neutral

Somewhat comfortable

Very comfortable


Are you aware of the MammaPrintAre you aware of the MammaPrint®® assay? assay?

100% 49%Percent answering yes


Health & Medicine

Breast Adjuvant Chemotherapy