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Use of trastuzumab in patients with early breast cancer : a multi-institutional study

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Resumo:Breast cancer is the most common female cancer and the leading cause of cancer death among females worldwide. Breast cancer is a highly heterogeneous disease with several biological subtypes. Approximately 25% of patients are diagnosed with HER2-positive breast cancer, which classically was associated with poor prognosis. The development of a directed therapy towards HER2 receptor (in particular with trastuzumab) changed this scenario. Trastuzumab is a humanized monoclonal antibody that contributed to a dramatic prognostic improvement of HER2-positive disease. Firstly, this was demonstrated in the metastatic setting and subsequently in early-breast cancer. In 2005, several phase III randomized trials showed that adjuvant treatment of HER2-positive breast cancer with trastuzumab is associated with a reduction in the risk of cancer recurrence by 40% and mortality by 36%. The aim of this retrospective cohort study was to characterize the uptake of adjuvant trastuzumab use and describe patterns of use in a cohort of patients with stage I-III, HER2-positive breast cancer, diagnosed between 2006 and 2008 in a group of Portuguese institutions. Adherence to recommended treatment, therapy duration and effectiveness were also evaluated. We found a progressive increase in the utilization of trastuzumab from 2006- 2008. By 2008, 52% of patients with HER2-positive disease received adjuvant trastuzumab. The majority of the patients completed more than 75% of preconized duration of trastuzumab. In addition, all patients who were treated with trastuzumab received chemotherapy, most frequently sequential anthracycline-based non-intensive regimens. Trastuzumab used was associated with a survival improvement. In the group not treated with trastuzumab we observed 22 (24%) deaths, and in the group treated with the drug 15 (15.8%) deaths. In conclusion, following the first efficacy results of trastuzumab for patients with early HER2-positive breast cancer, this group of Portuguese institutions started to adopt this practice with substantial survival impact.
Autores principais:Francisco, Rudolfo Pais Mendes Ferreira
Assunto:Breast cancer HER2-positive Trastuzumab Overall survival Safety Mestrado Integrado - 2016
Ano:2016
País:Portugal
Tipo de documento:dissertação de mestrado
Tipo de acesso:acesso restrito
Instituição associada:Universidade de Lisboa
Idioma:inglês
Origem:Repositório da Universidade de Lisboa

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