Non-initiation and early discontinuation of adjuvant trastuzumab in women with localized HER2-positive breast cancer

• Published in: Breast cancer (Tokyo, Japan) Vol. 21; no. 6; pp. 780 - 785
• Main Authors: Neugut, Alfred I., Hillyer, Grace Clarke, Kushi, Lawrence H., Lamerato, Lois, Leoce, Nicole, Ambrosone, Christine B., Bovbjerg, Dana H., Mandelblatt, Jeanne S., Hershman, Dawn L.
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.11.2014; Springer
• Subjects: Adjuvant treatment; Adult; Aged; Analysis; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Antimitotic agents; Antineoplastic agents; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Cancer; Cancer Research; Care and treatment; Chemotherapy, Adjuvant; Cohort Studies; Female; Humans; Medical research; Medication Adherence; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Oncology; Prognosis; Prospective Studies; Rapid Communication; Receptor, ErbB-2 - metabolism; Surgery; Surgical Oncology; Trastuzumab; Treatment Outcome; Women; Adherence; Early discontinuation; Breast cancer; Trastuzumab; Adjuvant therapy; Non-initiation
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-014-0543-1

One year of trastuzumab therapy is recommended for women with HER2-positive breast cancer ≥1.0 cm in size to increase survival and is considered for women with tumors 0.5–0.9 cm in size. We analyzed compliance with trastuzumab among women with HER2-positive breast cancer in a prospective cohort study. Of 1145 recruited patients with breast cancer, 152 were HER2-positive (13.2 %), of whom 126 had tumors ≥1.0 cm; 110/126 (87.3 %) of these initiated trastuzumab. Non-receipt was associated with older age, better prognosis tumors, and with non-receipt of adjuvant chemotherapy. Of the 110 who initiated treatment, 18 (15 %) did not complete treatment, 15 (83 %) of them because of cardiotoxicity. Of 20 women with tumors 0.5–0.9 cm, 5 (25 %) initiated trastuzumab. Compliance with trastuzumab was very high among those with HER2-positive breast cancer, as was the completion of the recommended therapy.