Trastuzumab treatment of patients with early, HER2-positive breast cancer in 17 certified German breast cancer centers
| Autor: | Christoph Kowalski, Friedemann Schad, Lorenz Rieger, Barbara Brückner, Simone Wesselmann, Andreas D. Hartkopf, Jens Uwe Blohmer, Christoph Lindner, Marina Dos Santos Guilherme, Olaf Ortmann, Clara Breidenbach, Nora Tabea Sibert, Elisabeth C. Inwald, Susanne Peschel, Gerhard Gebauer, Julia Ferencz, Sebastian Dieng, Paul Strecker |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Receptor ErbB-2 medicine.medical_treatment Breast Neoplasms 03 medical and health sciences Antineoplastic Agents Immunological 0302 clinical medicine Breast cancer Trastuzumab Internal medicine medicine Humans Practice Patterns Physicians' skin and connective tissue diseases neoplasms Aged Chemotherapy business.industry Confounding Cancer General Medicine Guideline Odds ratio Middle Aged Prognosis medicine.disease Confidence interval 030104 developmental biology 030220 oncology & carcinogenesis Practice Guidelines as Topic Female business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of Cancer Research and Clinical Oncology. 148:719-726 |
| ISSN: | 1432-1335 0171-5216 |
| DOI: | 10.1007/s00432-021-03651-1 |
| Popis: | Since 2008, guidelines recommend that patients with HER2-positive early breast cancer (BC) should receive adjuvant chemotherapy in combination with trastuzumab in Germany. However, recent studies highlight that a substantial share of patients do not receive trastuzumab. We investigate which patient characteristics are associated with a tumor board recommendation for trastuzumab in Breast Cancer Centers (BCC) certified by the German Cancer Society (DKG) and the German Society for Senology, and if the recommendation differs between BCCs. Multi-level modeling was performed using quality assurance data based on 3052 HER2-positive, operated patients with a first diagnosis of early BC treated between 2006 and 2019 in 17 BCCs in Germany to investigate whether trastuzumab recommendation varies with patient sex, age, and disease characteristics, as well as over time and across BCCs. Tumor board recommendations for trastuzumab differ substantially between BCCs (intraclass correlation coefficient [ICC] null model: 0.11). Our final model (ICC 0.17, Akaike Information Criterion [AIC], 1328.0, R2 0.69) shows that physicians in BCCs more often recommend trastuzumab to patients who are younger than 60 years and those with a recommendation for any additional therapy (chemotherapy, radiation or endocrine therapy) (all p |
| Databáze: | OpenAIRE |
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