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Purpose: We report treatments and outcomes in a contemporary patient population with HER2-positive metastatic breast cancer (MBC) by hormone receptor (HR) status from the Systemic Therapies for HER2-positive Metastatic Breast Cancer Study (SystHERs)., Experimental Design: SystHERs (NCT01615068) was an observational, prospective registry study of U.S.-based patients with newly diagnosed HER2-positive MBC. Endpoints included treatment patterns and clinical outcomes., Results: Of 977 eligible patients (enrolled from 2012 to 2016), 70.1% ( n = 685) had HR-positive and 29.9% ( n = 292) had HR-negative disease. Overall, 59.1% (405/685) of patients with HR-positive disease received any first-line endocrine therapy (with or without HER2-targeted therapy or chemotherapy); 34.9% (239/685) received HER2-targeted therapy + chemotherapy + sequential endocrine therapy. Patients with HR-positive versus HR-negative disease had longer median overall survival (OS; 53.0 vs 43.4 months; hazard ratio, 0.70; 95% confidence interval, 0.56-0.87). Compared with patients with high HR-positive staining (10%-100%, n = 550), those with low HR-positive staining (1%-9%, n = 60) received endocrine therapy less commonly (64.2% vs 33.3%) and had shorter median OS (53.8 vs 40.1 months). Similar median OS (43.4 vs 40.1 months) was observed in patients with HR-negative versus low HR-positive tumors (1%-9%)., Conclusions: Despite evidence that first-line HER2-targeted therapy, chemotherapy, and sequential endocrine therapy improves survival in patients with HR-positive, HER2-positive disease, only 34.9% of patients in this real-world setting received such treatment. Patients with low tumor HR positivity (1%-9%) had lower endocrine therapy use and worse survival than those with high tumor HR positivity (10%-100%)., (©2020 American Association for Cancer Research.)

Aims: Acute myeloid leukemia (AML) treatment typically involves remission induction chemotherapy followed by consolidation chemotherapy. New treatments for AML have recently been introduced, including a chemotherapy formulation called CPX-351, which is administered via less time-intensive IV infusion than the standard "7 + 3" continuous infusion regimen of cytarabine plus an anthracycline. The purpose of this study was to estimate utilities that could be used in economic modeling of AML treatment. Materials and methods: In time trade-off interviews, participants from the UK general population valued 12 health states drafted based on literature and clinician interviews. To identify disutility associated with chemotherapy, two types of induction and four types of consolidation were added to an otherwise identical health state describing AML. The decrease in utility when adding these chemotherapy regimens represents the disutility of each regimen. Five additional health states were valued to estimate utilities associated with other AML treatments. Results: Two hundred participants completed interviews. Mean (SD) utilities were 0.55 (0.31) for pre-treatment AML and 0.66 (0.29) for AML in temporary remission. Adding any chemotherapy significantly decreased utility ( p  < 0.0001). Induction had a mean disutility of -0.11 with CPX-351 and -0.15 with 7 + 3. Mean disutility for consolidation ranged from -0.03 with outpatient CPX-351 to -0.11 with inpatient 5 + 2. Utilities are also reported for other AML treatments (e.g. transplant, low-intensity chemotherapy). Limitations: One limitation is that the differences in adverse event profiles between the treatment regimens were based on clinician opinion. Future use of CPX-351 in clinical trials or clinical settings will provide additional information on its adverse event profile. Conclusions: While all chemotherapy regimens were associated with disutility, regimens with shorter hospitalization and less time-intensive infusion were generally perceived as preferable. These utilities may be useful in cost-utility models comparing the value of AML treatments.

Two patients diagnosed with advanced head and neck cancer were treated with cetuximab 400 mg/m 2 intravenously for one loading dose followed by 250 mg/m 2 IV on days 1, 8, and 15 along with paclitaxel 80 mg/m 2 and cisplatin 30 mg/m 2 intravenously on days 1 and 8 repeated every 21 days for three cycles (CPP). Maintenance cetuximab 250 mg/m 2 intravenously weekly was continued following the aforementioned regimen for one year or until disease progression. Patient A was diagnosed with squamous cell carcinoma of the parotid gland treated initially with parotidectomy and radiation therapy. After the detection of multiple lung metastases, he received three cycles of CPP and maintained a stable disease after one year. Patient B was diagnosed with metastatic laryngeal cancer and was initially treated with three cycles of docetaxel, cisplatin, and continuous infusion fluorouracil (TPF) followed by chemoradiation with cisplatin. After one year, recurrence was observed, and she was treated with laryngopharyngectomy. After another year, recurrence was observed , and CPP was initiated. Further progression was noted shortly after completion of cycle 3. There are limited data supporting the use of regimens similar to CPP in advanced head and neck cancer. Further study is needed to determine the relative efficacy and safety of CPP compared with other regimens containing monoclonal antibodies targeting the epidermal growth factor receptor, taxanes, platinum agents, and/or fluorouracil.