With the goal of improving therapeutic options for breast cancer patients, Aidan Gilbert, MPH, a second-year medical student at the USA College of Medicine, recently studied the treatment patterns of nearly 1,700 patients with metastatic breast cancer (MBC).
Using data visualization – graphic representations of information and data – he examined the sequence of treatments and how those patterns related to patient survival.
“Metastatic breast cancer is a debilitating terminal disease that affects thousands of women each year,” Gilbert said. “I think it’s of the utmost importance for physicians and researchers to continue research in this field in an attempt to improve therapeutic options, whether that is the development of novel treatments, or more in line with what we have done here in trying to understand treatment patterns that may confer survival benefits.”
Results from the study, “Utilizing Data Visualization to Identify Survival and Treatment Differences Between Women with De Novo and Recurrent Metastatic Breast Cancer,” were published in Clinical Breast Cancer, a peer-reviewed bimonthly journal.
De novo is stage IV breast cancer in which the patient has metastatic disease on day one of diagnosis. Recurrent metastatic breast cancer is when the patient presents with early stage (I-III) cancer; receives surgery, chemotherapy or both; and then later develops metastatic disease.
There are three major subtypes of breast cancer: hormone receptor positive and human epidermal growth factor receptor 2 negative (HR+/HER2-); human epidermal growth factor receptor 2 positive (HER2+); and triple negative, meaning HR negative and HER2 negative (TNBC).
“Using data visualization techniques that we developed, our study found that, when stratified by the three major breast cancer subtypes, and de novo versus recurrent metastatic breast cancer, there were observable differences in treatment sequencing and survival,” Gilbert said.
The most significant clinical findings were:
- HER2-targeted therapy is used across the continuum of the cancer course in both de novo and recurrent disease.
- In HR+/HER2- breast cancer, chemotherapy is administered more often early in the course of disease for patients with de novo breast cancer than those with recurrent metastatic breast cancer. So, there is a more aggressive treatment approach up front in de novo compared to recurrent.
- Treatment breaks are common amongst patients with long survival in triple negative breast cancer.
The treatment patterns and survival differences between de novo and recurrent MBC means there is a distinction between them. Therefore, Gilbert said, “they should be considered that way and not just under the umbrella of metastatic breast cancer.”
Gilbert said data visualization techniques, in conjunction with more traditional statistical analyses, can be useful in predicting the success of an entire treatment course from the point of diagnosis rather than the immediate effects of an individual treatment.
