CARDIAC-STAR: prevalence of cardiovascular comorbidities in patients with HR + /HER2 − metastatic breast cancer

Figures

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  Fig. 1. Study design. A high-level overview of the study design and methodology is presented. Additional information, including detailed definitions of eligibility criteria and outcomes, is provided in the Methods section. aExcept for non-melanoma of the skin. BC, breast cancer; CV, cardiovascular; HER2 + , human epidermal growth factor receptor 2-positive; HER2 − , human epidermal growth factor receptor 2-negative; HR + , hormone receptor-positive; mBC, metastatic breast cancer; QTc, heart rate-corrected QT interval

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  Fig. 2. Flowchart of patients included in the study. The flowchart shows the selection of patients included in the analysis. aIn Marketscan Commercial Claims and Encounters (CCAE) database & Medicare Supplemental and Coordination of Benefits (MDCR) database. bDefined as ≥ 2 claims containing ≥ 1 diagnosis code for breast cancer ≥ 30 days apart. cDefined as ≥ 2 claims for a secondary neoplasm on separate days (with the first claim occurring ≤ 30 days before or any time after the first diagnosis of primary breast cancer); patients who solely had secondary malignancy diagnosis codes of the breast, local regional lymph nodes, or non-melanoma of the skin were not considered to have mBC. dDefined as patients who received ≥ 1 prescription fill of endocrine therapy on or before index date or within 30 days after index date. eDuring − 12/ + 6 months prior and post index date. fUse before index date or within 30 days after index date. gDuring the look-back period, except for non-melanoma of the skin. HER2 + , human epidermal growth factor receptor 2-positive; HR + , hormone receptor-positive; mBC, metastatic breast cancer

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  Fig. 3. Medications with risk of QTc prolongation used for > 30 days. The proportions of patients with or without CV comorbidities who received 0, 1, or ≥ 2 medications with a risk of QTc prolongation are presented. CV, cardiovascular; QTc, heart rate-corrected QT interval

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  Fig. 4. Medications with risk of TdP used for > 30 days. The proportions of patients with or without CV comorbidities who received ≥ 1 medication with a known, possible, or conditional risk of TdP are presented. aDrugs that prolong QTc and are clearly associated with a known risk of TdP, even when taken as recommended. bDrugs that can cause QTc prolongation but currently lack evidence for a risk of TdP when taken as recommended. cDrugs that are associated with TdP, but only under certain conditions of their use or by creating conditions that facilitate or induce TdP. CV, cardiovascular; QTc, heart rate-corrected QT interval; TdP, Torsades de Pointes

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  Fig. 5. First documented treatment after mBC diagnosis. First documented treatments after mBC diagnosis are presented for patients with or without CV comorbidities, stratified by year of mBC diagnosis (2016–2017 or 2018–2022). CDK4/6, cyclin-dependent kinase 4/6; CV, cardiovascular; ET, endocrine therapy; mBC, metastatic breast cancer

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  Fig. 6. First documented treatment after mBC diagnosis: CDK4/6 inhibitors. Among patients with or without CV comorbidities who received a CDK4/6 inhibitor as the first documented treatment for mBC (n = 1721), the proportions of those who received palbociclib, ribociclib, or abemaciclib are presented. CDK4/6, cyclin-dependent kinase 4/6; CV, cardiovascular; mBC, metastatic breast cancer