Real-world data shows ADC treatment rates increased 3.7-fold with faster access, yet older women (ages 66+) faced rates 3.4 times lower than younger patients

On the 40th anniversary of Breast Cancer Awareness Month, a new analysis from Komodo Health, the leader in AI-powered healthcare intelligence, conducted in collaboration with the Tigerlily Foundation, a national breast cancer patient advocacy organization, delivers critical insights into antibody-drug conjugate (ADC) treatment patterns in metastatic breast cancer. The study confirms growing clinical acceptance of this innovative therapy but also reveals persistent inequities in access based on age and insurance status.

The analysis of real-world treatment patterns found encouraging signs of progress: ADC treatment rates increased 3.7-fold from 2021 to 2023, rising from 1,353 to 4,965 per 100,000 newly diagnosed metastatic breast cancer patients. Accompanying this rapid adoption, the median time to treatment decreased from 331 to 109 days.

However, an analysis of age and insurance status revealed a disparity: Women age 66 and older had the lowest ADC treatment rates and experienced a median of 242 days to treatment, 3.4 times lower than the treatment rate seen in the youngest cohort, ages 19 to 35.

These findings were uncovered using Komodo's healthcare-native AI platform, Marmot™, which rapidly analyzes complex care patterns in minutes. Marmot provided the evidentiary-grade insights needed to confirm the momentum of therapeutic innovation while addressing systemic inequities.

“The encouraging patterns we see in this analysis — where ADC utilization aligns with disease biology — suggest that equitable outcomes are possible in precision medicine. Understanding the factors that contributed to these patterns can inform future therapeutic development," said Maimah Karmo, CEO and Founder, Tigerlily Foundation. "However, the question of why older women have significantly lower treatment rates remains critical and demands investigation to ensure appropriate care for all patients.”

Breakthroughs and Barriers in ADC Access

Leveraging its Healthcare Map^®, which tracks the healthcare journeys of over 330 million de-identified U.S. patients, Komodo analyzed treatment patterns among roughly 17,000 women newly diagnosed with metastatic breast cancer who received treatment with three key FDA-approved ADCs — Kadcyla^®, Enhertu^®, and Trodelvy^® — between 2021 and 2023. The analysis revealed additional insights, including:

• Encouraging alignment with disease biology. Despite similar overall metastatic breast cancer incidence rates between White and Black women, ADC usage patterns differed substantially, aligning with known cancer subtypes. Black women had the highest overall ADC treatment rate, primarily driven by Trodelvy^® use for triple-negative breast cancer, a subtype more common in this population.¹ Asian women showed higher rates of HER2-targeted ADCs (Enhertu^®, Kadcyla^®), while White women had lower overall ADC usage, consistent with different breast cancer subtype distributions.
• Access barriers. Medicaid claims showed patients with the highest treatment rates, nearly twice the rate of patients insured by Medicare and higher than commercially insured patients.

The Power of Real-World Intelligence

“Our analysis uncovers a dual reality of precision oncology today: the progress in quickly adopting life-saving therapies like ADCs, coupled with systemic barriers that create disparate access for older patients,” said Tabby Khan, MD, MPH, Senior Director of Analytics, Komodo Health. “By leveraging the speed and precision of Marmot, we were able to not only track progress but also pinpoint these critical gaps to health equity, empowering the entire healthcare ecosystem with the evidentiary view and data needed to understand where policy and practice must be adapted to ensure every patient, regardless of age, benefits from innovative therapeutics.”

Read the full research brief here.

Reference: 1. Siddharth S, Sharma D. Racial Disparity and Triple-Negative Breast Cancer in African-American Women: A Multifaceted Affair between Obesity, Biology, and Socioeconomic Determinants. Cancers. 2018;10(12):514. https://doi.org/10.3390/cancers10120514

About Komodo Health

Komodo Health is the leader in healthcare intelligence, building the foundational AI that is powering the future of how Life Sciences and healthcare organizations discover, develop, and deliver patient care. By deploying Marmot, its proprietary AI engine, across its Healthcare Map, the industry’s most authoritative and highest-fidelity platform for real-world de-identified patient insights, Komodo is ending the era of slow, fragmented analyses. Komodo’s healthcare-native AI platform makes it possible to answer complex questions with the speed and rigor required to accelerate critical decisions across the product life cycle — from trial design to launch strategy to post-market evidence generation — to ultimately reduce the burden of disease. For more information, visit Komodohealth.com.

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"By leveraging the speed and precision of Marmot, we were able to not only track progress but also pinpoint these critical gaps to health equity," said Tabby Khan, MD, MPH, Senior Director of Analytics, Komodo Health.