Background: Precision medicine in oncology is often guided by the molecular characteristics of patients. Emerging real-world oncology databases linking genomic and clinical data (e.g., GENIE-BPC) can therefore be particularly informative. However, in terms of patient and clinical characteristics, the comparability of these emerging databases with other established databases has not been comprehensively assessed.
Objectives: To describe demographics, clinical characteristics, treatment patterns, and overall survival in breast cancer cohorts among GENIE-BPC and other three real-world databases.
Methods: This study utilized GENIE-BPC (American Association for Cancer Research Project Genomics Evidence Neoplasia Information Exchange Biopharma Collaborative, AACR GENIE BPC v1.1-consortium), SEER (Surveillance, Epidemiology and End Results), SEER-Medicare and MarketScan (IBM MarketScan Commercial and Medicare Supplemental) databases. Female patients with invasive breast cancer, diagnosed during 2010-17 (GENIE-BPC), 2010-18 (SEER and Marketscan) and 2010-16 (SEER-Medicare), were identified using electronic health records (GENIE-BPC), cancer registry (SEER and SEER-Medicare) or ICD-9/10-CM codes (MarketScan). The age requirements were 18-56 years at the time of sequencing (GENIE-BPC), or 18+ years (SEER and Marketscan Database) and 65+ years (SEER-Medicare) at initial breast cancer diagnosis. Received treatments were measured based on EHR-extracted information (GENIE-BPC) or HCPCS/NDC in medical and pharmacy claims of MarketScan and SEER-Medicare databases. Overall survival was estimated as time from diagnosis to death in GENIE-BPC (left truncation applied), SEER and SEER-Medicare databases.
Results: Of female breast cancer patients identified in GENIE-BPC (n=775), SEER (n=548,336), SEER-Medicare (n=68,914) and Marketscan (n=109,499) databases, the respective median ages were 44, 62, 74, and 57 years. A greater proportion of patients in GENIE-BPC, compared to SEER/SEER-Medicare, had higher grades (%III-IV: 57% vs 26%/24%), advanced stage (%IV: 25.3% vs 5%/3.6%), triple negative breast cancer (19.7% vs 10.2%/8.5%), as well as received chemotherapy (85.0% vs NA/22.3%). The 1-, 3- and 5-year cumulative death rates were higher in GENIE-BPC (21.6%, 39.5%, 44.5%, after left truncation), compared to SEER (4.2%, 10.5%, 14.5%) and SEER-Medicare (8.4%, 18.6%, 25.0%).
Conclusions: Compared to SEER, SEER-Medicare and Marketscan Databases, breast cancer patients in GENIE-BPC were younger and had more advanced disease, triple negative breast cancer subtype, and receipt of chemotherapy. These demographic and clinical characteristic differences may partially explain poorer survival in GENIE-BPC breast cancer patients.
