Survival outcomes with 12 weeks of adjuvant or neoadjuvant trastuzumab in breast cancer
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Date
2022-09
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer - Medknow
Abstract
Background: There is limited access to 1 year of adjuvant trastuzumab in resource-constrained settings. Most randomized studies have failed to prove non-inferiority of shorter durations of adjuvant trastuzumab compared to 1 year However, shorter durations are often used when 1 year is not financially viable. We report the outcomes with 12 weeks of trastuzumab administered as part of curative-intent treatment. Methods: This is a retrospective analysis of patients treated at Tata Memorial Centre, Mumbai, a tertiary care cancer center in India. Patients with human epidermal growth factor receptor (HER2)-positive early or locally advanced breast cancer who received 12 weeks of adjuvant or neoadjuvant trastuzumab with paclitaxel and four cycles of an anthracycline-based regimen in either sequence, through a patient assistance program between January 2011 and December 2012, were analyzed for disease-free survival (DFS), overall survival (OS), and toxicity. Results: A total of 102 patients were analyzed with a data cutoff in September 2019. The median follow-up was 72 months (range 6–90 months), the median age was 46 (24–65) years, 51 (50%) were postmenopausal, 37 (36%) were hormone receptor-positive, and 61 (60%) had stage-III disease. There were 37 DFS events and 26 had OS events. The 5-year DFS was 66% (95% Confidence Interval [CI] 56–75%) and the OS was 76% (95% CI 67–85%), respectively. Cardiac dysfunction developed in 11 (10.7%) patients. Conclusion: The use of neoadjuvant or adjuvant 12-week trastuzumab-paclitaxel in sequence with four anthracycline-based regimens resulted in acceptable long-term outcomes in a group of patients, most of whom had advanced-stage nonmetastatic breast cancer.
Description
Keywords
Adjuvant, neoadjuvant, resource constrained, short course, trastuzumab breast
Citation
Ghosh Joydeep, Phillip Deepa S Joy, Ghosh Jaya, Bajpai Jyoti, Gulia Seema, Parmar Vani, Nair Nita, Joshi Shalaka, Sarin Rajiv, Budrukkar Ashwini N, Wadasadawala Tabassum, Desai Sangeeta B, Shet Tanuja, Patil Asawari, Sawant Sheela P, Dhir Aruna A, Kembhavi Seema, Popat Palak, Hawaldar Rohini, Kembhavi Yogesh, Perumal Prema, Banavali Shripad D, Badwe Rajendra A, Gupta Sudeep. Survival outcomes with 12 weeks of adjuvant or neoadjuvant trastuzumab in breast cancer. Indian Journal of Cancer . 2022 Sep; 59(3): 387-393