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CC BY 4.0 · Brazilian Journal of Oncology 2022; 18: e-20220339
DOI: 10.5935/2526-8732.20220339
Original Article
Clinical Oncology

Analysis of trastuzumab therapy's efficacy with or without pertuzumab combination in the metastatic HER2-positive breast cancer an oncology hospital of Pernambuco

Análise da eficácia da terapia com trastuzumabe com ou sem combinação de pertuzumabe no câncer de mama HER2-positivo metastático em um hospital oncológico de Pernambuco
Kaline Nascimento dos Santos Lima 
1   Hospital de Câncer de Pernambuco, Oncologia - Recife - Pernambuco - Brazil
,
Juvanier Romão Cruz 
1   Hospital de Câncer de Pernambuco, Oncologia - Recife - Pernambuco - Brazil
,
Amanda Florentino Fonseca de Carvalho 
1   Hospital de Câncer de Pernambuco, Oncologia - Recife - Pernambuco - Brazil
› Author Affiliations Financial support: None to declare.
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ABSTRACT

Objectives: To evaluate the efficacy between trastuzumab-only or pertuzumab plus trastuzumab therapies in metastatic HER2-positive breast cancer patients.

Material and Methods: At Hospital de Cancer de Pernambuco (HCP), Recife, Brazil, a cross-sectional study was carried out. One hundred seventy-two patients with HER2-positive metastatic breast cancer (BC) were divided into two groups. One group of patients underwent chemotherapy with trastuzumab-only between 2013 and 2016, and another group underwent treatment with pertuzumab plus trastuzumab (P+H) between 2017 and 2020.

Results: The median age was 50.4 years (range 25-86) when diagnosed with tumor metastasis. The patients treated with trastuzumab-only had a mortality rate of 13/100 women per year (95% CI: 9.19 to 18.38), and those treated with trastuzumab plus pertuzumab had a mortality rate of 4.14/100 women per year (95% CI: 2.50 to 6.87). The estimated risk ratio (HR) for the trastuzumab-only group was 3.16-fold higher death than the P+H-treated group. The group of patients who evolved into metastasis during follow-up had a risk 3.12-fold higher of death compared to the group in tumor metastases at early diagnosis. In the multivariate analysis, the HR estimate adjusted for the trastuzumab-only treated group was 3.58-fold higher death than the P+H group. The mean follow-up time was three years (15 days to 14.7 years). The estimated mortality rate was 7.73/100 diagnosed women per year (95% CI: 5.80 to 10.3). In the analysis of overall survival (OS), there was a significant difference between the groups treated with trastuzumab-only or P+H (p<0.0001).

Conclusion: There are benefits in incorporating new therapies into Brazil's public health network for the treatment of women with metastatic HER2-positive breast cancer, impacting increased OS and better quality of life, even those diagnosed in more advanced stages.

RESUMO

Objetivos: Avaliar a eficácia entre terapias apenas com trastuzumabe ou pertuzumabe mais trastuzumabe, em pacientes com câncer de mama HER2-positivo metastático.

Material e Métodos: Foi realizado um estudo transversal no Hospital de Câncer de Pernambuco (HCP), Recife, Brasil. Cento e setenta e dois pacientes com câncer de mama (CM) HER2-positivo metastático foram divididos em dois grupos. Um grupo de pacientes foi submetido à quimioterapia apenas com trastuzumabe, entre 2013 e 2016; e outro grupo foi submetido ao tratamento com pertuzumabe mais trastuzumabe (P+H) entre 2017 e 2020.

Resultados: A idade mediana foi de 50,4 anos (variação 25-86) quando diagnosticada com metástase tumoral. Os pacientes tratados apenas com trastuzumabe tiveram uma taxa de mortalidade de 13/100 mulheres por ano (IC 95%: 9,19 a 18,38), e aqueles tratados com trastuzumabe mais pertuzumabe tiveram uma taxa de mortalidade de 4,14/100 mulheres por ano (IC 95%: 2,50 a 6,87). A razão de risco estimada (HR) para o grupo tratado apenas com trastuzumabe foi 3,16 vezes maior que o grupo tratado com P+H. O grupo de pacientes que evoluiu para metástase durante o seguimento apresentou risco 3,12 vezes maior de óbito em relação ao grupo em metástases tumorais no diagnóstico precoce. Na análise multivariada, a estimativa de FC ajustada para o grupo tratado apenas com trastuzumabe foi 3,58 vezes maior de óbito do que o grupo P+H. O tempo médio de seguimento foi de três anos (15 dias a 14,7 anos). A taxa de mortalidade estimada foi de 7,73/100 mulheres diagnosticadas por ano (IC 95%: 5,80 a 10,3). Na análise da sobrevida global (SG), houve diferença significativa entre os grupos tratados apenas com trastuzumabe ou P+H (p<0,0001).

Conclusão: Há benefícios na incorporação de novas terapias na rede pública de saúde do Brasil para o tratamento de mulheres com câncer de mama HER2-positivo metastático, impactando no aumento da SG e melhor qualidade de vida, mesmo naquelas diagnosticadas em estágios mais avançados.

Keywords:

Breast neoplasms - Receptor - ErbB-2 - Antibodies - Monoclonal

Descritores:

Neoplasias mamárias - Receptor - ErbB-2 - Anticorpos - Monoclonais


Publication History

Received: 25 February 2022

Accepted: 08 April 2022

Article published online:
22 June 2022

© 2022. 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/)

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Bibliographical Record
Kaline Nascimento dos Santos Lima, Juvanier Romão Cruz, Amanda Florentino Fonseca de Carvalho. Analysis of trastuzumab therapy's efficacy with or without pertuzumab combination in the metastatic HER2-positive breast cancer an oncology hospital of Pernambuco. Brazilian Journal of Oncology 2022; 18: e-20220339.
DOI: 10.5935/2526-8732.20220339
 

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