PhD defence Wilhelmina Maria Meegdes

Keywords: Metastatic, Breast cancer, Treatment, CDK4/6 inhibitors

"Breaking the cycle in HR+/HER2- metastatic breast cancer: Real-world data on treatment and outcomes"

This thesis evaluates real-world data on the treatment of metastatic breast cancer, with data from the Netherlands Cancer Register and the SONABRE Registry. The SONABRE Registry collects data of all patients with metastatic breast cancer in 11 hospitals in the Southeast of the Netherlands. Since 2017 CDK4/6 inhibitors are a new treatment for patients with hormone receptor positive metastatic breast cancer. CDK4/6 inhibitors were given to 50% of patients in the first two years beyond implementation date, and meanwhile the use of chemotherapy declined. The overall survival of these patients increased by 8 months between 2008-2010 and 2017-2019, due to new treatment strategies. Along with this, there is still improvement needed in the treatment of early-stage breast cancer with high-risk features, to prevent the development of metastatic disease. Furthermore, the receptor subtypes of breast cancer were evaluated and in 18% of patients the receptor subtype changed between primary breast tumour and first metastasis. In 60% of patients a biopsy was done at initial diagnosis of metastatic disease, this should be done more regularly.

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