Efficacy and safety of short course adjuvant trastuzumab combination chemotherapy in breast cancer

Abstract

Background: The adjuvant short course 9-week trastuzumab combination therapy for human epidermal receptor 2 positive breast cancer patients may often be considered as a cost-effective and safe option and has important implications for the Indian subcontinent as well as other developing countries. However, such regimens of shorter duration trastuzumab therapy like FinHer, offered in view of economic constraints, may not be able to achieve globally comparable cure rates in early breast cancer especially with high-risk women with more than 3 lymph node positive. Methods and Material: Outcome of 21 patients with HER2 positive breast cancer was treated with short course trastuzumab combination chemotherapy in the adjuvant setting was studied. Results: Out of 21 patients 15 are alive and disease free with a follow up of up to 73 months (median follow up 42 months).

Key words

FinHer - short course trastuzumab - survival

Publication History

Article published online:
22 December 2020

• References

• 1 Nagrani RT, Budukh A, Koyande S, Panse NS, Mhatre SS, Badwe R. Rural urban differences in breast cancer in India. Indian J Cancer 2014;51:277-81.
• 2 Goss PE, Strasser-Weippl K, Lee-Bychkovsky BL, Fan L, Li J, Chavarri-Guerra Y, et al. Challenges to effective cancer control in China, India, and Russia. Lancet Oncol 2014;15:489-538.
• 3 Parikh PM, Gupta S, Dawood S, Rugo H, Bhattacharyya GS, Agarwal A, et al. ICON 2013: Practical consensus recommendations for hormone receptor-positive Her2-negative advanced or metastatic breastcancer. Indian J Cancer 2014;51:73-9.
• 4 Dikshit RP, Yeole BB, Nagrani R, Dhillon P, Badwe R, Bray F. Increase in breast cancer incidence among older women in Mumbai: 30-year trends and predictions to 2025. Cancer Epidemiol 2012;36:e215-20.
• 5 Ghosh J, Gupta S, Desai S, Shet T, Radhakrishnan S, Suryavanshi P, et al. Estrogen, progesterone and HER2 receptor expression in breast tumors of patients, and their usage of HER2-targeted therapy, in a tertiary care centre in India. Indian J Cancer 2011;48:391-6.
• 6 Mates M, Fletcher GG, Freedman OC, Eisen A, Gandhi S, Trudeau ME, et al. Systemic targeted therapy for her2-positive early female breast cancer: A systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline. Curr Oncol 2015;22 Suppl 1:S114-22.
• 7 Singh R, Gupta S, Pawar SB, Pawar RS, Gandham SV, Prabhudesai S. Evaluation of ER, PR and HER-2 receptor expression in breast cancer patients presenting to a semi urban cancer centre in Western India. J Cancer Res Ther 2014;10:26-8.
• 8 National Cancer Registry Programme. Three Years Report of Population Based Cancer Registries 2009-2011. New Delhi: Indian Council of Medical Research; 2013.
• 9 Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005;55:74-108.
• 10 Pinto AC, Ades F, de Azambuja E, Piccart-Gebhart M. Trastuzumab for patients with HER2 positive breast cancer: Delivery, duration and combination therapies. Breast 2013;22 Suppl 2:S152-5.
• 11 Joensuu H, Bono P, Kataja V, Alanko T, Kokko R, Asola R, et al. Fluorouracil, epirubicin, and cyclophosphamide with either docetaxel or vinorelbine, with or without trastuzumab, as adjuvant treatments of breast cancer: Final results of the FinHer trial. J Clin Oncol 2009;27:5685-92.
• 12 Purmonen TT, Pänkäläinen E, Turunen JH, Asseburg C, Martikainen JA. Short-course adjuvant trastuzumab therapy in early stage breast cancer in Finland: Cost-effectiveness and value of information analysis based on the 5-year follow-up results of the FinHer trial. Acta Oncol 2011;50:344-52.
• 13 Isik M, Dizdar O, Altundag K. Two important determinants may play a role in the success of the FinHer trial. J Clin Oncol 2010;28:e334.
• 14 Paydas S, Basaran G, Saip P, Dogu GG, Eralp Y, Uslu R. et al. Nine Versus 52 Weeks of Adjuvant Trastuzumab in Early Breast Cancer: An Observational Study of the Turkish Oncology Group. Presented at the American Society of Clinical Oncology 2011 Annual Meeting 2011. ASCO #629;2011.
• 15 Tonyali O, Coskun U, Sener N, Inanc M, Akman T, Oksuzoglu B, et al. Nine-week trastuzumab treatment versus 52-week trastuzumab treatment for HER2-positive early-stage breast cancer. J Cancer Res Clin Oncol 2012;138:2145-51.
• 16 Sendur MA, Aksoy S, Ozdemir NY, Yazici O, Zengin N, Altundag K. et al. The efficacy of adjuvant trastuzumab in HER-2 positive breast cancer with axillary lymph node metastases according to the treatment duration. Curr Med Res Opin 2014;30:2535-42. doi: 10.1185/03007995.2014.965775. Epub 2014 Sep 29.
• 17 Jana D, Mandal S, Mukhopadhyay M, Mitra D, Mukhopadhyay SK, Sarkar DK. Prognostic significance of HER-2/neu and survival of breast cancer patients attending a specialized breast clinic in Kolkata, Eastern India. Asian Pac J Cancer Prev 2012;13:3851-5.
• 18 Vaidyanathan K, Kumar P, Reddy CO, Deshmane V, Somasundaram K, Mukherjee G. ErbB-2 expression and its association with other biological parameters of breast cancer among Indian women. Indian J Cancer 2010;47:8-15.
• 19 Pivot X, Romieu G, Debled M, Pierga JY, Kerbrat P, Bachelot T, et al. 6 months versus 12 months of adjuvant trastuzumab for patients with HER2-positive early breast cancer (PHARE): A randomised phase 3 trial. Lancet Oncol 2013;14:741-8.