Evidence map›Paper›PMID 39150586›Full record

ArticleBreast cancer research and treatment2024

The landscape of use of NCCN-guideline chemotherapy regimens in stage I-IIIA breast cancer in an integrated healthcare delivery system.

Jenna Bhimani, Kelli O'Connell, Sonia Persaud, Victoria Blinder, Rachael P Burganowski, Isaac J Ergas, Grace B Gallagher, Jennifer J Griggs, Narre Heon, Tatjana Kolevska and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Patient Characteristics Associated with Intended Nonguideline Chemotherapy in Women with Stage I to IIIA Breast Cancer.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Jenna BhimaniDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Kelli O'ConnellDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Sonia PersaudDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Victoria BlinderDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Rachael P BurganowskiKaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA.
Isaac J ErgasDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Grace B GallagherDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Jennifer J GriggsDepartment of Medicine, Division of Hematology/Oncology and Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA.
Narre HeonDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Tatjana KolevskaDepartment of Oncology, Kaiser Permanente Medical Center, Vallejo, CA, USA.
Yuriy KotsurovskyyDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Candyce H KroenkeDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Cecile A LaurentDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Raymond LiuDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Kanichi G NakataKaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA.
Donna R RiveraDivision of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
Janise M RohDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Sara TabatabaiDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Emily ValiceDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Elisa V BanderaCancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
Erin J Aiello BowlesKaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA.
Lawrence H KushiDivision of Research, Kaiser Permanente Northern California, Oakland, CA, USA.
Elizabeth D KantorDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA. kantore@mskcc.org.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
Risk-based Imaging Strategies to Improve Breast Cancer Surveillance OutcomesP01CA154292 · NCI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Diana L Miglioretti · 2011 to 2026
$52.9M
Translational Research Support CoreP30ES005022 · NIEHS · UNIV OF MED/DENT NJ-R W JOHNSON MED SCH · PI BRIAN T BUCKLEY · 1988 to 2026
$47.4M
Infrastructure for Pathways, a Prospective Study of Breast Cancer SurvivorshipU01CA195565 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI AMBROSONE, CHRISTINE B., KUSHI, LAWRENCE H · 2016 to 2025
$18.8M
CRN4: Cancer Research Resources & Collaboration in Integrated Health Care SystemsU24CA171524 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI KUSHI, LAWRENCE H · 2012 to 2016
$16.0M
Obesity, chemotherapy dosing, and breast cancer outcomesR37CA222793 · NCI · SLOAN-KETTERING INST CAN RESEARCH · PI KANTOR, ELIZABETH DAVID · 2018 to 2024
$4.0M
Group Health Cancer Research Program Research Specialist AwardR50CA211115 · NCI · KAISER FOUNDATION RESEARCH INSTITUTE · PI BOWLES, ERIN JANELLE AIELLO · 2017 to 2021
$919k
National Cancer Institute of the National Institute of Health, United States R50CA211115National Cancer Institute of the National Institute of Health, United States U24CA171524NCI NIH HHS P01 CA154292NCI NIH HHS P01CA154292NCI NIH HHS P30 CA008748NCI NIH HHS R37 CA222793NCI NIH HHS R50 CA211115NCI NIH HHS U01 CA195565NCI NIH HHS U24 CA171524
6 · The paper itself

Abstract

purposeThe National Comprehensive Cancer Network (NCCN) guidelines recommend a variety of drug combinations with specific administration schedules for the treatment of early-stage breast cancer, allowing physicians to deliver treatments recognizing individual patient complexities, including comorbidities, and patient-physician preference. While use of guideline regimens has shifted over time, there is little data to describe changes in how treatment for early-stage breast cancer has evolved over time.

methodsIn a cohort of 34,109 women treated for stage I-IIIA breast cancer between 2006-2019 at Kaiser Permanente Northern California and Kaiser Permanente Washington, we present the changes in chemotherapy regimens over time, and explore use of NCCN-guideline regimens (GR), guideline regimens used when said regimens were not included in guidelines, referred to as time-discordant regimens (TDR), and non-guideline regimens (NGR). Results are presented by drug combination and over time.

resultsAmong 12,506 women receiving chemotherapy, 77.4% (n = 9681) received GRs, 9.1% (n = 1140) received TDRs, and 13.5% (n = 1685) received NGRs. In 2006, AC-T (cyclophosphamide-doxorubicin, paclitaxel) was the most common regimen, with TC (cyclophosphamide-docetaxel) becoming the most prevalent by 2019. NGRs were more common in cyclophosphamide-methotrexate-5-fluorouracil (CMF); cyclophosphamide-doxorubicin-paclitaxel-trastuzumab (ACTH); and paclitaxel-trastuzumab (TH). The use of GR has increased over time (p-trend < 0.001), while use of NGR (both in terms of administration schedule and drug combination) and TDR have decreased, although patterns vary by drug combination.

conclusionChemotherapy delivery has changed markedly over time, with a move toward more use of GR. These data are important for understanding the landscape of chemotherapy delivery in community healthcare settings.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsDelivery of Health Care, IntegratedNeoplasm StagingPractice Guidelines as TopicAdultAgedCaliforniaFemaleGuideline AdherenceHumansMiddle AgedAdherence guidelineBreast cancerChemotherapyClinical practice patterns

Identifiers

PMID39150586
PMCPMC12045552

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.