Metastatic breast cancer (mBC) is the stage of breast cancer at which the tumor has spread beyond the breast to other organs in the body.1, 2 Also known as advanced breast cancer (aBC), stage IV breast cancer, or secondary breast cancer, mBC cannot currently be cured and is attributable to the majority of breast cancer deaths around the world.3,4,5 Furthermore, the number of deaths due to mBC is projected to increase by 43% over the next 15 years.6

There are key attributes that distinguish mBC:

  • While some patients initially are diagnosed with metastatic disease, the majority are diagnosed following an earlier diagnosis of breast cancer that has developed into metastatic disease.4,7 Globally, of the patients diagnosed with early breast cancer (eBC), 20-30% on average are anticipated to eventually develop metastatic disease; however, this can vary dependent on socio-economic status.7 The diagnosis of mBC often represents a time of shock, crisis, and anxiety for patients and their families.8,9
  • Median survival for mBC is an estimated 2-3 years; however, this can vary greatly among patients dependent on mBC subtype and other patient characteristics. Some patients can live with their disease for several years longer.1,10,11 This indefinite prognosis can leave patients and their families experiencing high levels of uncertainty and significant emotional burden.8
Although I stay as positive as possible, there is always the horrible doubt of ‘what if’ and ‘when.’
— mBC Patient, from Secondary Breast Cancer Research, BCNA, 20148
  • Although mBC can affect both men and women, approximately 99% of patients with mBC are women, most commonly in middle to late stages of life.12 Many patients may be responsible for organizing and running their households, caring for their families—including parents and younger children—as well as maintaining a job. The impact of the disease and its treatment may hinder patients’ ability to complete daily tasks such as driving to work or school and maintaining the home.13 Patients with mBC may therefore require assistance with these daily tasks that they were previously able to complete with ease.

  • mBC also is associated with many misperceptions and cultural stigmas, often directly impacting patients living with the disease.8,14 In a global survey, 48%-76% of the general population believed that advanced breast cancer is curable. Furthermore, on average, 28% of the general population indicated that patients with mBC should keep it a secret and not discuss it with anyone.8 These extreme perceptions of mBC result in patients experiencing social rejection, isolation and feeling misunderstood, particularly within the breast cancer community.8
People don’t understand the word metastatic to begin with.…And when I’d tell them I was stage IV, they’d give me pity or stay away or see me a year later and think I was a ghost. They couldn’t believe I was alive.
— US mBC patient, fredhutch.org, 20148
People would rather have AIDS than cancer; they know that they can survive AIDS but do not think they can survive cancer.…In Zambia, cancer equals death.
— Udie Soko, Co-founder and Executive Director at the Zambian Cancer Society, Zambia, 20158
[Our] goal is to make sure that the voices of women living with mBC are heard during Breast Cancer Awareness Month because so much is going on and most of it relates to early-stage: ‘Let’s look for a cure;’ ‘Treatment is better;’ ‘Diagnosis is better.’ But there’s still a large number [of patients] who are becoming metastatic.
— US Patient Support Organization8

 

Metastatic breast cancer (mBC) patient needs

Based on the limited understanding of the needs surrounding patients with mBC, Pfizer Inc., working collaboratively with the European School of Oncology (ESO) and within the scope of the Advanced Breast Cancer Third International Consensus Conference (ABC3), commissioned The Global Status of Advanced/Metastatic Breast Cancer 2005-2015 Decade Report15 to better understand the unique needs of patients living with mBC. This report is the first globally-focused assessment of mBC across the care continuum as well as the political, economic, societal, and scientific landscapes. It reveals both improvements over the past decade and substantial, continuing gaps in care, including access to resources and support. The report also highlights that there have only been incremental improvements in treatment outcomes for patients with mBC.8

Primary and secondary research, completed to inform the report, uncovered persistent unmet needs of patients living with mBC throughout their disease continuum:8

  • Patients living with mBC need comprehensive, individualized, compassionate, and culturally sensitive dialogue with their doctors which can support shared decision-making
  • The far-reaching effect of mBC on patient quality of life is not yet adequately measured and addressed. There is a need for greater focus and research into the factors that impact quality of life and effective psychosocial interventions to maximize this measure in patients living with mBC
  • Patients living with mBC need multidisciplinary, comprehensive approaches to care, with greater focus on support outside of treatment decision-making
  • There is a need for greater public understanding about mBC and what the diagnosis really means in order to address patients' feelings of isolation or stigma
  • Patients living with mBC and their families need more tailored and relevant information regarding their specific disease, from their healthcare provider team

With the current state of mBC in mind, Pfizer would like to take the next step towards advancing care for this patient group including addressing their unique challenges. Pfizer hopes that through the development of a worldwide innovation challenge, the innovation community* and mBC community will work together to develop solutions that will further meet the complex and unique needs of patients with this disease.

* The “innovation community” includes entrepreneurs, designers developers, and healthcare professionals who seek to develop new approaches and solutions to tackle issues in health and improve care delivery.