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Khoirunnisa SM, Suryanegara FDA, de Jong LA, Setiawan D, Postma MJ. A Systematic Review of Health-Related Quality of Life in Women with HER2-Positive Metastatic Breast Cancer Treated with Trastuzumab. PHARMACOECONOMICS - OPEN 2024; 8:511-524. [PMID: 38489021 PMCID: PMC11252097 DOI: 10.1007/s41669-024-00478-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Many trials of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer treatment with trastuzumab have provided evidence of improved clinical outcomes. This systematic review examined how a regimen that includes trastuzumab affects patients' health-related quality of life (HRQoL) during and after treatment. METHODS A systematic search for articles published up to February 2023 without restrictions of language or publication year was performed using the Pubmed, Embase, and Scopus databases. We included studies of women aged > 18 years with metastatic HER2-positive breast cancer treated with a trastuzumab-containing regimen. We assessed the quality of the studies using the Cochrane Risk of Bias (RoB) tool (2.0) for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomised Studies-of Interventions (ROBINS-I) tool for cross-sectional studies. We used Microsoft Excel to extract and synthesize data, and documented the review procedure following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In total, eight studies compared 1104 trastuzumab-treated patients and 1003 non-trastuzumab-treated patients. Most studies were RCTs (n = 7) and one was a prospective observational study. All the included studies used the EORTC-QLQ-C30, EORTC-QLQ-BR23, FACT-B, or FACT-G questionnaires. During treatment, patients taking regimens that included trastuzumab showed clinical improvement in HRQoL, social functioning, and role functioning. After the treatment, patients' HRQoL profiles in the trastuzumab and chemotherapy arms were similar. However, trastuzumab (versus chemotherapy) treatment led to clinically improved functional status, role and physical functioning, and fatigue. The quality assessment revealed some concerns in most RCTs, with the risk of bias being high in two studies, low in one study, and moderate in the cross-sectional study. CONCLUSIONS Trastuzumab-containing regimens administered to HER2-positive breast cancer patients at the metastatic stage evidenced beneficial effects on total HRQoL during and after treatment. Upon therapy cessation, patients' HRQoL scores for both interventions improved. Nevertheless, HRQoL profiles of patients treated with trastuzumab were more favorable, particularly for functional status, role functioning, physical well-being, and fatigue. CLINICAL TRIALS REGISTRATION This review was registered in PROSPERO (registration number: CRD42021259826).
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Affiliation(s)
- Sudewi Mukaromah Khoirunnisa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands.
- Science in Healthy Aging and healthcaRE (SHARE) Institute, University of Groningen, 9713 GZ, Groningen, The Netherlands.
- Department of Pharmacy, Institut Teknologi Sumatera, Lampung Selatan, 35365, Indonesia.
| | - Fithria Dyah Ayu Suryanegara
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Science in Healthy Aging and healthcaRE (SHARE) Institute, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta, 55584, Indonesia
| | - Lisa Aniek de Jong
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Science in Healthy Aging and healthcaRE (SHARE) Institute, University of Groningen, 9713 GZ, Groningen, The Netherlands
| | - Didik Setiawan
- Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Banyumas, 53182, Indonesia
- Centre for Health Economic Studies, Universitas Muhammadiyah Purwokerto, Banyumas, 53182, Indonesia
| | - Maarten Jacobus Postma
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Science in Healthy Aging and healthcaRE (SHARE) Institute, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, 9713 GZ, Groningen, The Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, 60115, Indonesia
- Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, 45363, Indonesia
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Alonso Torres AM, Arévalo Bernabé AG, Becerril Ríos N, Hellín Gil MF, Martínez Sesmero JM, Meca Lallana V, Ramió-Torrentà L, Rodríguez-Antigüedad A, Gómez Maldonado L, Triana Junco I, Gómez-Barrera M, Espinoza Cámac N, Oyagüez I. Cost-Analysis of Subcutaneous vs Intravenous Administration of Natalizumab Based on Patient Care Pathway in Multiple Sclerosis in Spain. PHARMACOECONOMICS - OPEN 2023; 7:431-441. [PMID: 36802327 PMCID: PMC10169937 DOI: 10.1007/s41669-023-00394-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 05/11/2023]
Abstract
INTRODUCTION A subcutaneous (SC) formulation of natalizumab has been recently authorised for multiple sclerosis patients. This study aimed to assess the implications of the new SC formulation, and to compare the annual treatment costs of SC versus intravenous (IV) natalizumab therapy from both the Spanish healthcare system (direct health cost) and the patient (indirect cost) perspectives. METHODS A patient care pathway map and a cost-minimisation analysis were developed to estimate SC and IV natalizumab annual costs over a 2-year time horizon. Considering the patient care pathway and according to natalizumab experience (IV) or estimation (SC), a national expert panel involving neurologists, pharmacists, and nurses provided information/data regarding resource consumption for drug and patient preparation, administration, and documentation. One hour of observation was applied to the first six (SC) or 12 (IV) doses, and 5 min for successive doses. The Day hospital (infusion suite) facilities at a reference hospital were considered for IV administrations and the first six SC injections. For successive SC injections, either a reference hospital or regional hospital in a consulting room was considered. Productivity time associated with travel (56 min to reference hospital, 24 min to regional hospital) and waiting time pre- and post-treatment (SC 15 min, IV 25 min) were assessed for patients and caregivers (accompanying 20% of SC and 35% of IV administrations). National salaries for healthcare professionals were used for cost estimation (€, year 2021). RESULTS At years 1 and 2, total time and cost savings (excluding drug acquisition cost) per patient, driven by saving on administration and patient and caregiver productivity for SC at a reference hospital versus IV at a reference hospital, were 116 h (a reduction of 54.6%) and €3682.82 (a reduction of 66.2%). In the case of natalizumab SC at a regional hospital, the total time and cost saving were 129 h (a reduction of 60.6%) and €3883.47 (a reduction of 69.8%). CONCLUSIONS Besides the potential benefits of convenient administration and improving work-life balance, as suggested by the expert panel, natalizumab SC was associated with cost savings for the healthcare system by avoiding drug preparation, reducing administration time, and freeing up infusion suite capacity. Additional cost savings could be derived with regional hospital administration of natalizumab SC by reducing productivity loss.
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Affiliation(s)
- A M Alonso Torres
- Neurology Department, Hospital Universitario de Málaga, Málaga, Spain
| | | | | | - M F Hellín Gil
- Specialised Nurse, Hospital Virgen Arrixaca, Murcia, Spain
| | | | - V Meca Lallana
- Neurology Department, Hospital Universitario La Princesa, Madrid, Spain
| | - Ll Ramió-Torrentà
- Neurology Department, Hospital Universitario Josep Trueta, Girona, Spain
| | | | | | | | - M Gómez-Barrera
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
| | - N Espinoza Cámac
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain.
| | - I Oyagüez
- Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
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Lin HW, Lin CY, Yeh TP, Lin TC, Yeh WC, Yang LC, Chen YC, Chiu LY, Wu CT, Chen CJ, Chen YF, Wang HC, Wu YC, Liu LC. Quality of care in the course of subcutaneous versus intravenous trastuzumab administration in patients with breast cancer: an integrated time-motion study with mixed-methods research. BMJ Open 2023; 13:e059288. [PMID: 36927581 PMCID: PMC10030473 DOI: 10.1136/bmjopen-2021-059288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES This study aimed to compare the time required and concerns raised by various perspectives of participants regarding administering subcutaneous and intravenous trastuzumab for patients with breast cancer (BC). DESIGN This observational time-motion study design with mixed-methods research (cross-sectional surveys and semistructured interviews) was conducted. The time spent on preparing or administering trastuzumab by different healthcare professionals (HCPs) was recorded. The data were analysed by descriptive/inferential statistical analyses, followed by thematic analyses. SETTING Outpatient and inpatient administration units of a single medical centre in Taiwan. PARTICIPANTS The study included patients with early-stage BC who received subcutaneous or intravenous trastuzumab (n=93), and HCPs including two attending physicians, a nurse practitioner, two pharmacists and two nurses. RESULT Based on the perspectives of patients and HCPs, the subcutaneous form of trastuzumab was more efficient, less expensive and produced less discomfort in outpatient units than inpatient units. More participants preferred the subcutaneous form over the intravenous form in both outpatient and inpatient units. Pharmacists and nurse practitioners spent threefold more time on patients when preparing and administering the intravenous form in both outpatient and inpatient units. The concerns raised by patients and HCPs varied in certain aspects, including the injection skills, speed, mental distress (eg, needle phobia) and pain associated with the subcutaneous form. Almost all patients preferred receiving the subcutaneous form in outpatient units after the initial COVID-19 outbreak. CONCLUSION Patients with early-stage BC preferred receiving subcutaneous trastuzumab in outpatient units rather than inpatient units or the intravenous form before and after the COVID-19 outbreak. Such findings may serve as real-world evidence to facilitate better quality of care regarding administration of subcutaneous or intravenous trastuzumab in medical settings, and its feasible resolutions to balance the quality, concerns and efficiency of anticancer administration during the COVID-19 pandemic.
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Affiliation(s)
- Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan
- Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chen-Yuan Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan
- Division of Hematology and Oncology, China Medical University Hospital, Taichung, Taiwan
| | - Tzu-Pei Yeh
- School of Nursing, China Medical University, Taichung, Taiwan
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Tien-Chao Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Wan-Chen Yeh
- Department of Nursing, China Medical University Hospital, Taichung, Taiwan
| | - Lin-Chun Yang
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan
| | - Yu-Chieh Chen
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Li-Ying Chiu
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chen-Teng Wu
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Jung Chen
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Fen Chen
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
| | - Hwei-Chung Wang
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
| | - Yao-Chung Wu
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
| | - Liang-Chih Liu
- Surgical Department, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Khoirunnisa SM, Suryanegara FDA, Setiawan D, Postma MJ. Health-related quality of life in Her2-positive early breast cancer woman using trastuzumab: A systematic review and meta-analysis. Front Pharmacol 2023; 14:1090326. [PMID: 37124232 PMCID: PMC10140570 DOI: 10.3389/fphar.2023.1090326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 03/31/2023] [Indexed: 05/02/2023] Open
Abstract
Background: Despite the benefits of trastuzumab in many trials, evidence of its impact on health-related quality of life (HRQoL) in early treatment has not been summarized. This study explored the effects of trastuzumab treatment on HRQoL, including pooled meta-analysis, in an effort to provide an integrated assessment of HRQoL for Her2-positive early breast cancer patients. Methods: A comprehensive literature review to February 2023 using three databases, focusing on treatment using trastuzumab during the early stage, was performed. The mean changes from baseline during and after treatment were extracted from the included randomized control trials (RCTs) papers and total HRQoL scores were obtained from cross-sectional studies included. Mean difference (MD) and 95% confidence intervals were assessed by a random effect or fixed effect model based on heterogeneity (I2). Results: A total of ten studies were identified and reviewed, consisting of seven RCTs and three cross-sectional studies. The pooled analysis of the mean change from baseline during treatment resulted in an MD of 1.92 (95% CI = 1.59 to 2.25, p < 0.05, I2 = 0%), favoring the trastuzumab group. A non-significant result of the mean change from baseline after treatment appeared in the analysis of 12-month follow-up. In the cross-sectional studies, pooled analyses of HRQoL showed that trastuzumab meaningfully demonstrated an improved HRQoL profile (MD = 9.29, 95% CI = 1.31 to 17.27, p = 0.02, I2 = 0%). Conclusion: Trastuzumab as a targeted therapy resulted in a favorable effect on HRQoL in the early stages of Her2-positive breast cancer. The findings of significant improvements in patients' HRQoL and less clinically meaningful deterioration in side effects of trastuzumab-containing regimen during treatment were supported by prolonged survival.
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Affiliation(s)
- Sudewi Mukaromah Khoirunnisa
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Pharmacy, Institut Teknologi Sumatera, Lampung Selatan, Indonesia
- *Correspondence: Sudewi Mukaromah Khoirunnisa, ,
| | - Fithria Dyah Ayu Suryanegara
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Pharmacy, Universitas Islam Indonesia, Yogyakarta, Indonesia
| | - Didik Setiawan
- Faculty of Pharmacy, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia
- Center for Health Economic Studies, Universitas Muhammadiyah Purwokerto, Banyumas, Indonesia
| | - Maarten Jacobus Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Economics, Econometrics and Finance, University of Groningen, Groningen, Netherlands
- Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
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Li W, Zhang Q, Cai Y, Chen T, Cheng H. The COMT Genetic Factor Regulates Chemotherapy-Related Prospective Memory Impairment in Survivors With HER2-/+ Breast Cancer. Front Oncol 2022; 12:816923. [PMID: 35211407 PMCID: PMC8861381 DOI: 10.3389/fonc.2022.816923] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/12/2022] [Indexed: 12/19/2022] Open
Abstract
Background Previous findings indicated that polymorphism in gene catechol-O-methyltransferase (COMT) had been linked to chemotherapy-related cognitive impairment (CRCI). Nevertheless, the motivation of COMT polymorphisms in regulating cognitive impairment in breast cancer survivors with disparate status of human epidermal growth factor receptor 2 (HER2) was still vague. Objective The current research aimed to evaluate the regulation of the risk by COMT genotype on CRCI in breast cancer survivors with disparate status of HER2. Methods Breast cancer survivors (103 with HER2− and 118 with HER2+) underwent neuropsychological tests before and after chemotherapy, containing event- and time-based prospective memory (EBPM and TBPM). Three single-nucleotide polymorphisms (SNPs) were estimated by providing peripheral blood, containing COMT (rs165599, rs737865, and rs4680). Results The EBPM and TBPM performances was lower as compared with these before chemotherapy (z = −7.712, z = −2.403, respectively, p < 0.01). Furthermore, the EBPM and TBPM performances of HER2− group survivors were lower than those of HER2+ group survivors after chemotherapy (z = −7.181, p < 0.01; z = −2.205 p < 0.05, respectively). The survivors with COMT (rs165599) A/A genotype carriers had a meaningfully poorer chance of memory descend [dominant model: adjusted, OR = 2.21, CI (95%) = 1.156–4.225, p = 0.016] and showed better on TBPM test, relative to G/G genotype. Patients with the COMT (rs737865) A/G and G/G genotype showed protective function than the patients with the A/A and performed better on MMSE and TBPM tests. Conclusion The types of HER2 may be correlated to chemotherapy-related prospective memory impairments in breast cancer survivors. Furthermore, the COMT (rs165599, rs737865) polymorphisms were correlated to the risk of TBPM decline scores and possibly be a potential genetic identifying for increasing risk of CRCI in breast cancer patients with disparate status of HER2.
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Affiliation(s)
- Wen Li
- Cancer Treatment Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qianqian Zhang
- Cancer Treatment Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yinlian Cai
- Cancer Treatment Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingting Chen
- Cancer Treatment Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huaidong Cheng
- Cancer Treatment Center, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Abad-Sazatornil MR, Arenaza A, Bayo J, García Mata J, Guinea De Castro JM, León J, Letellez J, Reguero V, Martínez Chamorro C, Salar A. Impact of the subcutaneous formulations of trastuzumab and rituximab on efficiency and resource optimization in Spanish hospitals: H-Excelencia study. BMC Health Serv Res 2021; 21:320. [PMID: 33832464 PMCID: PMC8034176 DOI: 10.1186/s12913-021-06277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 03/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background Subcutaneous (SC) versus intravenous (IV) administration is advantageous in terms of patient convenience and hospital efficiency. This study aimed to compare the effect of optimizing the processes involved in SC versus IV administration of rituximab and trastuzumab on hospital capacity and service quality. Methods This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases. Results Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60–66%. Conclusions Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06277-8.
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Affiliation(s)
| | - Ainhoa Arenaza
- Hospital Pharmacy, Hospital Clínico San Carlos, Madrid, Spain
| | - Juan Bayo
- Oncology Unit, Hospital Juan Ramón Jiménez, Huelva, Spain
| | - Jesus García Mata
- Medical Oncology Unit, Complexo Hospitalario Universitario de Ourense, Ourense, Spain
| | | | - Josefa León
- Hospital Pharmacy, Hospital Morales Meseguer, Murcia, Spain
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Tripathy D, Blum JL, Rocque GB, Bardia A, Karuturi MS, Cappelleri JC, Liu Y, Zhang Z, Davis KL, Wang Y. POLARIS: a prospective, multicenter, noninterventional study assessing palbociclib in hormone receptor-positive advanced breast cancer. Future Oncol 2020; 16:2475-2485. [PMID: 32787449 DOI: 10.2217/fon-2020-0573] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This report describes the rationale, purpose and design of the POLARIS study. POLARIS is an ongoing noninterventional, prospective, multicenter study. Female and male patients in the USA and Canada diagnosed with hormone receptor-positive/HER2-negative metastatic breast cancer were enrolled in the study and treated with the cyclin-dependent kinase 4/6 inhibitor palbociclib when hormone receptor-positive/HER2-negative metastatic breast cancer was deemed to be indicated by their physician. The study will provide real-world data on palbociclib prescribing and treatment patterns in routine clinical practice, associated clinical outcomes, treatment sequencing in the advanced/metastatic setting, patient quality of life and geriatric-specific assessments. The tumor genomic landscape in relation to clinical outcomes will be explored. POLARIS will identify benefits and side effects of palbociclib across multiple lines of therapy and in discrete subsets of patients. Clinical Trial Registration: NCT03280303 (ClinicalTrials.gov).
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Affiliation(s)
- Debasish Tripathy
- The University of Texas MD Anderson Cancer Center, Breast Medical Oncology, Unit 1354, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Joanne L Blum
- Texas Oncology, 3410 Worth Street, Suite 400, Dallas, TX 75246, USA
| | - Gabrielle B Rocque
- The University of Alabama at Birmingham, 701 20th Street South, 1170 Administration Building, Birmingham, AL 35294, USA
| | - Aditya Bardia
- Massachusetts General Hospital, 55 Fruit Street, LRH 304, Boston, MA 02114, USA
| | - Meghan S Karuturi
- The University of Texas MD Anderson Cancer Center, Breast Medical Oncology, Unit 1354, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | | | - Yuan Liu
- Pfizer Inc, 235 E. 42nd Street, New York, NY 10017, USA
| | - Zhe Zhang
- Pfizer Inc, 235 E. 42nd Street, New York, NY 10017, USA
| | - Keith L Davis
- RTI Health Solutions, 3040 East Cornwallis Road, Research Triangle Park, NC 27709, USA
| | - Yao Wang
- Pfizer Inc, 235 E. 42nd Street, New York, NY 10017, USA
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Safety profile of subcutaneous trastuzumab in patients with HER2-positive early breast cancer: The French HERmione non-interventional prospective study. Breast 2019; 49:1-7. [PMID: 31670262 PMCID: PMC7375678 DOI: 10.1016/j.breast.2019.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 11/20/2022] Open
Abstract
Objectives HERmione study was conducted to assess, in human epidermal growth factor receptor 2 (HER2)-positive early breast cancer (eBC), the safety profile of subcutaneous (SC) formulation of trastuzumab in real-life in France. Materials and methods This prospective, non-interventional study included 511 patients planned to be treated in both neoadjuvant and adjuvant settings with a follow-up of 12 months maximum in 101 sites. The safety analyses concerned 505 patients. Primary endpoint was the description of systemic safety and local tolerability of the SC trastuzumab. Results The median age of patients was 58 years. Over the study, 2449 adverse events (AEs) occurred in 422 (83.6%) patients (asthenia, arthralgia, radiation skin injury, myalgia, hot flush and diarrhea in ≥10% of patients): 92 AEs (3.8%) were grade ≥3 (radiation skin injury in 1.8% of patients and febrile neutropenia in 1.4% of patients), 76 (3.1%) were serious (mainly febrile neutropenia in 1.4% of patients) and 336 (13.7%) were treatment-related (mainly injection site pain in 9.1% of patients). Congestive Heart Failure occurred in 58 (11.5%) patients and was related to treatment in 4.6% of patients. Only 34 AEs (1.4%) in 27 (5.4%) patients led to permanent treatment discontinuation. One death was assessed as not treatment-related. Quality of life (QoL) analyses showed no deterioration of global health status. Conclusion The HERmione study showed that, in a real-life setting, the safety of SC trastuzumab administered in HER2-positive eBC patients is consistent with data reported from previous clinical trials, without new safety concerns or QoL deterioration.
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