Download PDF
CC BY 4.0 · Brazilian Journal of Oncology 2024; 20: s00441790564
DOI: 10.1055/s-0044-1790564
Original Article
Clinical Oncology

Evaluation of Treatment and Recurrence-Free Survival in Patients with Early HER2-Positive Breast Cancer: Real-Life Data Comparing Public and Private Healthcare

Mariana Pilon Capella 
1   Clinical Oncology, Instituto Brasileiro de Controle do Câncer (IBCC Oncologia), São Paulo, SP, Brazil.
,
Viviane Lealdini 
1   Clinical Oncology, Instituto Brasileiro de Controle do Câncer (IBCC Oncologia), São Paulo, SP, Brazil.
,
Pedro Aguiar  Jr.
2   Discipline of Hematology and Oncology, Centro Universitário Faculdade de Medicina do ABC, Santo André, SP, Brazil.
› Author Affiliations Funding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.

Clinical Trials None.
› Further Information
   Permissions and Reprints All articles of this category

Abstract

Introduction The present study was designed to compare the treatment provided in private and public health care facilities for women positive for early breast cancer of the human epidermal growth factor receptor 2 (HER2) subtype, who received anti-HER2 therapy in neoadjuvant or adjuvant settings, with an evaluation of the recurrence-free survival (RFS) and pathological complete response (pCR) rates.

Materials and Methods The current is a retrospective study carried out at the Instituto Brasileiro de Controle do Cancer (IBCC Oncologia), in the city of São Paulo, Brazil. We included patients treated between 2015 and 2020.

Results The study included 472 medical records of early HER2-positive breast cancer patients treated in the public and private health care systems who received neoadjuvant or adjuvant treatments. The pathological complete response (pCR) was related to a lower recurrence rate and a longer recurrence-free survival (RFS). The results showed no statistically significant difference between the public and private health care systems in terms of RFS.

Discussion Although the public health care patients were diagnosed with more advanced diseases than the private health care patients, both presented similar survival rates. In spite of the small number of patients evaluated, the dual HER2 blockade did not improve the clinical outcomes. These findings should be confirmed through studies with a larger number of patients and a longer follow-up period.

Keywords

breast neoplasms - HER2-positive - treatment - neoadjuvant therapy - adjuvant chemotherapy

Author's Contributions

MPC: collection and assembly of data, conception and design, data analysis and interpretation, final approval of the manuscript, manuscript writing; VL: final approval of the manuscript and manuscript writing; and PAJ: data analysis and interpretation, final approval of the manuscript, and manuscript writing.




Publication History

Received: 18 March 2024

Accepted: 27 June 2024

Article published online:
02 October 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
Mariana Pilon Capella, Viviane Lealdini, Pedro Aguiar. Evaluation of Treatment and Recurrence-Free Survival in Patients with Early HER2-Positive Breast Cancer: Real-Life Data Comparing Public and Private Healthcare. Brazilian Journal of Oncology 2024; 20: s00441790564.
DOI: 10.1055/s-0044-1790564
 

  • References

  • 1 INCA (Brazil). In: Instituto Nacional do Câncer (Brazil). Estatísticas de câncer. (Brasília, DF): Instituto Nacional do Câncer; 2020. ; (Accessed in June 15, 2020). Available from: https://www.inca.gov.br/numeros-de-cancer
    Search in Google Scholar
  • 2 Magalhães M, Aguiar P, Haaland B, Del Giglio A, Lopes G. Meta-analysis in HER2+ early breast cancer therapies and cost-effectiveness in a Brazilian perspective. Ann Oncol 2019; 30 (05) 85
    Search in Google Scholar
  • 3 Ishii K, Morii N, Yamashiro H. Pertuzumab in the treatment of HER2-positive breast cancer: an evidence-based review of its safety, efficacy, and place in therapy. Core Evid 2019; 14: 51-70
    Search in Google Scholar
  • 4 Li S, Wei W, Jiang Y. et al. Comparison of the efficacy and survival analysis of neoadjuvant chemotherapy for Her-2-positive breast cancer. Drug Des Devel Ther 2018; 12: 3085-3093
    Search in Google Scholar
  • 5 Kong YC, Bhoo-Pathy N, Subramaniam S. et al. Advanced Stage at Presentation Remains a Major Factor Contributing to Breast Cancer Survival Disparity between Public and Private Hospitals in a Middle-Income Country. Int J Environ Res Public Health 2017; 14 (04) 427
    Search in Google Scholar
  • 6 Blackwell K, Gligorov J, Jacobs I, Twelves C. The Global Need for a Biosimilar Trastuzumab for Patients with HER2-Positive Breast Cancer. Clin Breast Cancer 2018; 18 (02) 95-113
    Search in Google Scholar
  • 7 Brasil. Ministério da Saúde. Diretrizes diagnósticas e terapêuticas do Ministério da Saúde. Sistema Único de Saúde. 2021 ; (Accessed February 5, 2021). Available from: http://bvsms.saude.gov.br/bvs/saudelegis/sctie/2017/prt0057_06_12_2017.html
    Search in Google Scholar
  • 8 Richard S, Selle F, Lotz JP, Khalil A, Gligorov J, Soares DG. Pertuzumab and trastuzumab: the rationale way to synergy. An Acad Bras Cienc 2016; 88 (Suppl 1, Suppl 1) 565-577
    Search in Google Scholar
  • 9 Anampa J, Makower D, Sparano JA. Progress in adjuvant chemotherapy for breast cancer: an overview. BMC Med 2015; 13: 195
    Search in Google Scholar
  • 10 Assis CF, Mamede M. A Mamografia e seus Desafios: Fatores Socioeducacionais Associados ao Diagnóstico Tardio do Câncer de Mama. Iniciação Científica Cesumar. 2016; 18 (01)
    Search in Google Scholar
  • 11 Rosa DD, Bines J, Werutsky G. et al. The impact of sociodemographic factors and health insurance coverage in the diagnosis and clinicopathological characteristics of breast cancer in Brazil: AMAZONA III study (GBECAM 0115). Breast Cancer Res Treat 2020; 183 (03) 749-757
    Search in Google Scholar
  • 12 Boukai A, Gonçalves AC, Padoan M. et al. Outcome of patients with breast cancer treated in a private health care institution in Brazil. J Glob Oncol 2018; 4: 1-10
    Search in Google Scholar
  • 13 Abrahão KdeS, Bergmann A, Aguiar SS, Thuler LCS. Determinants of advanced stage presentation of breast cancer in 87,969 Brazilian women. Maturitas 2015; 82 (04) 365-370
    Search in Google Scholar
  • 14 Piccart-Gebhart MJ, Procter M, Leyland-Jones B. et al; Herceptin Adjuvant (HERA) Trial Study Team. Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 2005; 353 (16) 1659-1672
    Search in Google Scholar
  • 15 Gianni L, Pienkowski T, Im YH. et al. 5-year analysis of neoadjuvant pertuzumab and trastuzumab in patients with locally advanced, inflammatory, or early-stage HER2-positive breast cancer (NeoSphere): a multicentre, open-label, phase 2 randomised trial. Lancet Oncol 2016; 17 (06) 791-800
    Search in Google Scholar
  • 16 Moja L, Tagliabue L, Balduzzi S. et al. Trastuzumab containing regimens for early breast cancer. Cochrane Database Syst Rev 2012; 2012 (04) CD006243
    Search in Google Scholar
  • 17 Santos TP, Paes MA, Ferreira ACSM, Campos T. Avaliação epidemiológica das pacientes com câncer de mama tratadas com trastuzumabe no Hospital de Base de Brasília. Rev Bras Oncol Clin 2014; 10 (36) 55-59 https://www.sboc.org.br/sboc-site/revista-sboc/edicoes/36.html
    Search in Google Scholar