Beta
ManageSearchChatDiscover
336310

The Impact of Trastuzumab Administration Patterns on the Long-Term Clinical Outcomes of Patients with Non-Metastatic Breast Cancer in a Resource-Limited Setting

Article

Last updated: 01 Jan 2025

OverviewSimilar Items

Subjects

-

Tags

-

Abstract

Background: Administration of trastuzumab (TRA) in resource-limited settings (RLS) is associated with significant deviations from per-label recommendations such as fixed-dose instead of weight-based, interruptions, and a reduced number of cycles. The impact of these deviations on the clinical outcomes of HER2-positive non-metastatic breast cancer is unclear.
Methods: We retrospectively reviewed the records of patients with operable HER2-positive breast cancer treated at our center from 2013 to 2018 for TRA dose deviations. The standard protocol for TRA administration includes a one-year course of TRA with one intravenous dose every three weeks for 17 cycles. We assessed the number of cycles, underdosing based on body weight calculation, and low relative dose intensity (RDI). Cox regression analysis was used to identify predictors of survival and was adjusted for baseline clinical variables.
Results: This analysis included 208 patients with a median age of 45 years. A total of 175 (84%) patients showed at least one per label deviation. Fifty-four patients (26%) were underdosed with a mean maintenance dose defect of 54 ±107 mg, 64 (31%) received a reduced number of courses (≤ 9 cycles), and 103 patients (49.5%) received TRA at low RDI. Reduced number of cycles was the only factor associated with a worse hazard of recurrence-free survival and overall survival (HR: 2.25, 95% CI: 1.35–3.75, adjusted p =0.002) and (HR: 2.48, 95% CI: 1.36-4.52, adjusted p =0.003), respectively.
Conclusion: In our cohort, not all the deviations had adverse impacts on clinical outcomes. Only a reduced number of cycles was associated with a worse recurrence-free and overall survival hazard. Improving access to anti-HER2 therapies in RLS is crucial. Ensuring the full course of TRA in RLS is needed.

DOI

10.21608/resoncol.2023.236479.1201

Keywords

breast cancer, Cost-effectiveness, HER2 positive, Resource-limited setting, Trastuzumab dose

Authors

First Name

Ahmed

Last Name

Abd-Elhafeez

MiddleName

A.M.

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

hbaboda@kasralainy.edu.eg

City

-

Orcid

-

First Name

Mohamed

Last Name

Hassan

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

hassanv22000@yahoo.com

City

-

Orcid

-

First Name

Doaa

Last Name

Almeldin

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

doaa.almeldin@kasralainy.edu.eg

City

Cairo

Orcid

-

First Name

Kirellos

Last Name

Abbas

MiddleName

S.

Affiliation

Faculty of Medicine, Alexandria University, Alexandria, Egypt

Email

kirellos.abbas1653@alexmed.edu.eg

City

Alexandria

Orcid

-

First Name

Basel

Last Name

Abdelazeem

MiddleName

-

Affiliation

Department of Internal Medicine, McLaren Health Care, Flint, Michigan, USA

Email

basel.abdelazeem@mclaren.org

City

Cairo

Orcid

-

First Name

Mina

Last Name

Saba

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

mina.m.saba@gmail.com

City

Cairo

Orcid

-

First Name

Esraa

Last Name

Ahmed

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

esrooahmed42@gmail.com

City

Cairo

Orcid

-

First Name

Kyrillus

Last Name

Shohdy

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

kyrillus.shohdy@nhs.net

City

Cairo

Orcid

-

First Name

Loay

Last Name

Kassem

MiddleName

-

Affiliation

Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

Email

loay.kassem@cairocure.com

City

Cairo

Orcid

-

Volume

19

Article Issue

2

Related Issue

45833

Issue Date

2023-12-01

Receive Date

2023-09-14

Publish Date

2023-12-01

Page Start

20

Page End

30

Print ISSN

2357-0687

Online ISSN

2357-0695

Article File

RESONCOL_Volume 19_Issue 2_Pages 20-30.pdf

PDF . 245.6kB

Link

https://resoncol.journals.ekb.eg/article_336310.html

Detail API

https://resoncol.journals.ekb.eg/service?article_code=336310

Order

1

Type

Original Article

Type Code

200

Publication Type

Journal

Publication Title

Research in Oncology

Publication Link

https://resoncol.journals.ekb.eg/

MainTitle

The Impact of Trastuzumab Administration Patterns on the Long-Term Clinical Outcomes of Patients with Non-Metastatic Breast Cancer in a Resource-Limited Setting

Details

Type

Article

Created At

30 Dec 2024