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. 2016 Mar 31:5:395.
doi: 10.1186/s40064-016-2008-9. eCollection 2016.

Survival in patients with non-metastatic breast cancer treated with adjuvant trastuzumab in clinical practice

Christopher M Gallagher  1 , Kenneth More  2 , Anthony Masaquel  3 , Tripthi Kamath  3 , Annie Guerin  4 , Raluca Ionescu-Ittu  4 , Roy Nitulescu  4 , Marjolaine Gauthier-Loiselle  4 , Nicholas Sicignano  5 , Elizabeth Butts  6 , Eric Q Wu  7 , Brian Barnett  3
Affiliations

Survival in patients with non-metastatic breast cancer treated with adjuvant trastuzumab in clinical practice

Christopher M Gallagher et al. Springerplus. .

Abstract

Purpose: The NSABP Trial B-31 and NCCTG Trial N9831 (B-31/N9831 trials, Romond et al. in N Engl J Med 353:1673-84, 2005. doi:10.1056/NEJMoa052122; Perez et al. in J Clin Oncol 32:3744-52, 2014. doi:10.1200/JCO.2014.55.5730) established the efficacy of adjuvant trastuzumab for patients with HER2-positive early stage breast cancer. We aimed to estimate the overall survival (OS) and relapse-free survival (RFS) of HER2-positive non-metastatic breast cancer patients treated with adjuvant trastuzumab in a clinical practice setting in the United States.

Methods: Adult women initiating adjuvant trastuzumab within 1 year of breast cancer surgery were identified in the health claims database of the US Department of Defense (01/2003-12/2012). OS and RFS unadjusted rates at 4 and 6 years after the first trastuzumab treatment following the breast cancer diagnosis were estimated from Kaplan-Meier analyses.

Results: The study sample included 3188 women followed for a median of 3.3 years after trastuzumab initiation and treated continuously with trastuzumab for a median of 12 months. The OS rates (95 % confidence intervals) at 4 and 6 years were 90.0 % (88.6-91.2) and 87.1 (85.3-88.6), respectively. The corresponding RFS rates were 75.8 % (74.0-77.5) and 72.7 (70.7-74.7), respectively. The OS and RFS rates at 6 years reported in the B-31/N9831 trials were 89.8 and 81.4 %, respectively.

Conclusions: OS rates estimated in this study were in range with those estimated in the B-31/N9831 trials, while RFS rates were lower. However, patients in the B-31/N9831 trials were younger and possibly had fewer comorbidities than patients in the current study; these differences were not adjusted for in the crude OS and RFS analyses.

Keywords: HER2-positive breast cancer; Overall survival; Relapse; Trastuzumab.

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Figures

Fig. 1
Fig. 1
Sample selection flowchart. Note The following international classification of diseases, ninth revision, clinical modification (ICD-9-CM) codes were used to identify female breast cancer: 174.x for primary female breast cancer and codes 196.x-199.x for secondary neoplasm, excluding 196.0, 196.1, 196.3 and 198.2, which may be used to indicate locally advanced breast cancer
Fig. 2
Fig. 2
Overall survival and relapse-free survival a in clinical setting versus the B-31/N9831 trials (data from Perez et al. JCO 2014 (Perez et al. 2014) were reproduced with author permission). a Overall survival. b Relapse-free survival
See this image and copyright information in PMC

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