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Br J Cancer. 2018 Feb 6;118(3):441-447. doi: 10.1038/bjc.2017.405. Epub 2017 Nov 14.

Survival outcomes for Australian women receiving trastuzumab for HER2-positive metastatic breast cancer following (neo)adjuvant trastuzumab: a national population-based observational study (2006-2014).

Author information

1
Medicines Policy Research Unit, Centre for Big Data Research in Health, University of New South Wales, Sydney, NSW 2052, Australia.
2
NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW 2050, Australia.
3
Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2050, Australia.
4
School of Medicine, University of Notre Dame Australia, Sydney, NSW 2050, Australia.
5
National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia.
6
Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA 02215, USA.
7
University of Queensland, Brisbane QLD 4072, Australia.

Abstract

BACKGROUND:

Patients treated with (neo)adjuvant trastuzumab who relapse and receive trastuzumab for metastatic breast cancer (MBC) are a growing population with little outcome data given their exclusion from most clinical trials. We aim to estimate survival outcomes for this trastuzumab 'pre-treated' population.

METHODS:

Population-based study of Australian women receiving trastuzumab for HER2-positive MBC between 2006 and 2014, who also received (neo)adjuvant trastuzumab. We used Kaplan-Meier methods to estimate the following: overall survival (OS) from initiation of trastuzumab for MBC; duration of trastuzumab for MBC; and time from last (neo)adjuvant trastuzumab to first trastuzumab for MBC.

RESULTS:

Of 3199 patients dispensed trastuzumab for MBC, 634 (20%) had received (neo)adjuvant traztuzumab. Pre-treated patients had a median (interquartile range) OS of 21.8 months (10.9-51.6), trastuzumab duration of 12.8 months (4.7-17.5), and time from last (neo)adjuvant trastuzumab to first trastuzumab for MBC of 15.6 months (6.5-28.6). Median OS for patients initiating trastuzumab <12 months and ⩾12 months from their last (neo)adjuvant trastuzumab were 17.1 months and 24.8 months, respectively.

CONCLUSIONS:

Patients starting trastuzumab for MBC following (neo)adjuvant trastuzumab had a median treatment duration of 1 year and OS of almost 2 years. These data help inform clinical practice and service planning for this under-researched population.

PMID:
29136405
PMCID:
PMC5808025
[Available on 2019-02-06]
DOI:
10.1038/bjc.2017.405

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