Utilizing Data Visualization to Identify Survival and Treatment Differences Between Women with De Novo and Recurrent Metastatic Breast Cancer

Structured Abstract: Introduction De novo stage IV metastatic breast cancer (MBC) and recurrent MBC are considered the same when determining guideline based care, but differences in treatment patterns exist. Data visualization can be used to understand these differences and optimize treatment delivery. Methods This retrospective study evaluated treatment patterns for de novo and recurrent MBC using the American Society of Clinical Oncology’s CancerLinQ Discovery® database. Spatiotemporal graphics depicting treatment data were generated for MBC subtype and stratified by de novo and recurrent MBC. Descriptive statistics for categorical and continuous variables were calculated. Results We identified 1,668 patients diagnosed and treated for MBC: 391 patients with HER2+ MBC, 767 patients with HR+/HER2- MBC, and 510 patients with triple negative MBC (TNBC). Median survival from MBC diagnosis for patients with de novo MBC and recurrent MBC was 1.4 years (IQR 0.6-3.0) and 1.8 years (IQR 0.7-4.5), respectively. Both patients with de novo and recurrent HER2+ MBC were often treated with continuous HER2-targeted therapy. Patients with de novo HR+/HER2- MBC often received chemotherapy followed by hormone therapy. This contrasted with treatment trends observed among patients with recurrent HR+/HER2- MBC who, after receiving chemotherapy, seldom went on to receive hormone therapy. Patients diagnosed with TNBC displayed less heterogeneous treatment trends. Conclusion There are observable differences in survival and practice patterns between de novo and recurrent MBC. Visualization techniques are effective in assessing large databases, and could give researchers and clinicians a clearer understanding of how survival differs by disease subtype, diagnosis status, and practice patterns.