Prognostic Factors and Survival Outcomes of Patients With Early HER2+ Breast Cancer Treated With Trastuzumab in a Brazilian Public Reference Center: A Real-World Study.

Autor: Mattar A; Hospital Pérola Byington, São Paulo, SP, Brazil; Hospital da Mulher, São Paulo, SP, Brazil; Oncoclínicas São Paulo, São Paulo, SP, Brazil. Electronic address: mattar.andre@gmail.com., Hegg R; Hospital Pérola Byington, São Paulo, SP, Brazil., Tayar DO; Roche Brazil, Rua Dr Rubens Gomes Bueno, São Paulo, SP, Brazil., Rocha M; Roche Brazil, Rua Dr Rubens Gomes Bueno, São Paulo, SP, Brazil., Terzian ALB; Roche Brazil, Rua Dr Rubens Gomes Bueno, São Paulo, SP, Brazil., Oliveira RW; IQVIA Brazil, Rua Verbo Divino, São Paulo, SP, Brazil., Julian GS; IQVIA Brazil, Rua Verbo Divino, São Paulo, SP, Brazil., Gebrim LH; Hospital Pérola Byington, São Paulo, SP, Brazil.
Jazyk: angličtina
Zdroj: Clinical breast cancer [Clin Breast Cancer] 2023 Dec; Vol. 23 (8), pp. 864-875.e7. Date of Electronic Publication: 2023 Sep 07.
DOI: 10.1016/j.clbc.2023.08.009
Abstrakt: Purpose: Trastuzumab was introduced into the Brazilian public health care service for early breast cancer (BC) in 2012. This study describes the survival outcomes and prognostic factors related to early HER2+ BC treatment in a Brazilian reference cancer center.
Patients and Methods: This were a retrospective, single-center, observational study of early HER2+ BC patients treated with trastuzumab in the (neo)adjuvant setting between 2012 and 2018 at Hospital Pérola Byington. Demographic, clinical, disease-free survival (DFS) and overall survival (OS) data were evaluated. Multivariate analysis was performed to assess independent prognostic factors.
Results: One hundred seventy-six and 353 patients treated in the neoadjuvant and adjuvant setting were included, respectively. The 3- and 5-year OS rates were 79% and 56% for the neoadjuvant group and 97% and 92% for the adjuvant group, respectively. Node positivity at diagnosis predicted poor OS for both groups. In the neoadjuvant group, stage III disease at diagnosis, delayed surgery, and lack of pathological complete response (pCR) predicted poor prognosis. The 3- and 5-year DFS rates were 67% and 46% in the neoadjuvant group and 91% and 86% in the adjuvant group, respectively. Histological grade 2, stage III disease at diagnosis, and lack of pCR predicted poor DFS for the neoadjuvant group. For the adjuvant group, node positivity at diagnosis predicted poor DFS.
Conclusion: Our results reveal multiple clinical parameters affecting survival outcomes according to the treatment setting. Patients treated with neoadjuvant therapy have a poor prognosis since they present with more advanced disease, indicating the importance of early diagnosis and optimized treatment.
Competing Interests: Disclosure The authors have stated that they have no conflicts of interest.
(Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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