The treatment of metastatic breast cancer aims to relieve symptoms by controlling disease and prolonging survival with better QOL. The meta-analysis demonstrated the significant advantage for overall survival by chemotherapy with a longer period. It means that chemotherapy can prolong survival. The major chemotherapies contain anthracyclines or taxanes. For HER 2-overexpressing breast cancer, a standard treatment utilizes trastuzumab-containing chemotherapy. The other active agents include vinorelbine, capecitabine, S-1, mitomycin and gemcitabine. Bisphosphonates combined with chemotherapy or hormone therapy are able to alleviate pain or complications of osteolytic bone metastasis. Experimental agents, such as monoclonal antibody or small molecular kinase inhibitor, are investigated for clinical use. The treatments, either chemotherapy or hormone therapy, could be performed in sequence in order to minimize toxicities and maximize efficacy. In selecting the most appropriate treatment for metastatic breast cancer, it is recommended to consider patients' preference by providing the correct information on the status of disease, efficacy and toxicities of chemotherapy.

Objectives To examine the economic burden of skeletal-related events (SREs) and to assess the frequency of different types of SREs in this population. Study design Retrospective claims analysis. Methods Data were obtained from i3's Lab Rx Database from May 1, 2000, through March 31, 2005. Patients included had at least 2 claims with a diagnosis of prostate cancer, at least 2 subsequent claims with a diagnosis of bone metastasis, and at least 1 SRE on or after the date of the initial diagnosis of bone metastasis. Descriptive statistics for 342 patients who fit all inclusion and exclusion criteria are provided, along with Kaplan-Meier curves, which were used to estimate annual costs, adjusting for the censoring of the data. Results Patients most frequently had radiation therapy (89%), followed by pathologic fracture (23%) and bone surgery (12%). Among patients diagnosed as having at least 1 SRE, 78% experienced 1 type of SRE, 17% had 2 types of SREs, and 5% had 3 or more distinct types of SREs. The mean costs associated with SREs in the year after the initial diagnosis of an SRE, adjusted for the censoring of the data, was $12,469, with the highest costs associated with radiation therapy ($5930), followed by pathologic fracture ($3179) and bone surgery ($2218). Conclusion This study of patients with prostate cancer and bone metastases revealed that the annual economic effect of medically treating SREs for these patients was $12,469.

The cost of treating skeletal-related events in patients with prostate cancer

Metastatic bone disease (MBD) is the most common cause of cancer pain and of serious skeletal-related events (SREs) reducing quality of life. Management of MBD involves a multimodal approach aimed at delaying the first SRE and reducing subsequent SREs. The objective of the study was to characterise the hospital burden of disease associated with MBD and SREs following breast, lung and prostate cancer in Spain. Patients admitted into a participating hospital, between 1 January 2003 and 31 December 2003, with one of the required cancers were identified and selected for inclusion into the study. The index admission to hospital, incidence of patients admitted and hospital length of stay were analysed. There were 28,162 patients identified with breast, lung and prostate cancer. The 3 year incidence rates of hospital admission due to MBD were 95 per 1000 for breast cancer, 156 per 1000 for lung cancer and 163 per 1000 for prostate cancer. For patients admitted following an SRE, the incidence rates were 211 per 1000 for breast cancer, 260 per 1000 for lung cancer and 150 per 1000 for prostate cancer. This study has shown that cancer patients consume progressively more hospital resources as MBD and subsequent SREs develop.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2354.2009.01135.x

The hospital burden of disease associated with bone metastases and skeletal-related events in patients with breast cancer, lung cancer, or prostate cancer in Spain.

Chemotherapy for metastatic breast cancer

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Chemotherapy for metastatic breast cancer

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The cost of treating skeletal-related events in patients with prostate cancer

The hospital burden of disease associated with bone metastases and skeletal-related events in patients with breast cancer, lung cancer, or prostate cancer in Spain.