EFFECTIVENESS OF ADJUVANT TRASTUZUMAB IN DAILY CLINICAL PRACTICE

Abstract

Introduction: HER2 positive breast cancer is an entity with aggressive behavior. One year of adjuvant trastuzumab significantly improve disease free survival in the range of 40-50% and reduce the risk of dying from HER2 positive breast cancer by one third.

Aim: Adjuvant treatment with trastuzumab became available in Slovenia in 2005 and the aim of this report is to explore if the exceptional results reported in adjuvant clinical trials are achieved also in daily clinical practice.

Patient and methods: An analysis of tumor and patient characteristics, type of treatment and outcome (relapse free and overall survival) of 313 patients (median age 52 years) treated at the Institute of Oncology Ljubljana in years 2005-2009 was performed.

Results: Median follow-up was 4.4 years. Sixty-one patients relapsed and 24 died. Three and four years relapse free survival was 84.2% and 80.8% and overall survival was 94.4% and 92.5%, respectively. Independent prognostic factors for relapse were tumor grade (HR 2.10; 95% CI 1.07-4.14; p=0.031) and nodal stage (HR 1.35; 1.16-1.56; p<0.0001) and for overall survival nodal stage only (HR 1.36; 1.05-1.78; p=0.021).

Conclusion:  Outcome in patients with adjuvant trastuzumab in daily clinical practice, treated by medical oncologists, is comparable to results obtained in international adjuvant studies.

Key words:

breast cancer, trastuzumab, adjuvant, daily clinical practice