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. 2017 Jan-Mar;38(1):22-27.
doi: 10.4103/0971-5851.203511.

Treatment Challenges and Survival Analysis of Human Epidermal Growth Factor Receptor 2-positive Breast Cancer in Real World

Praveen Adusumilli  1 , Meher Lakshmi Konatam  1 , Sadashivudu Gundeti  1 , Stalin Bala  1 , Lakshmi Srinivas Maddali  1
Affiliations

Treatment Challenges and Survival Analysis of Human Epidermal Growth Factor Receptor 2-positive Breast Cancer in Real World

Praveen Adusumilli et al. Indian J Med Paediatr Oncol. 2017 Jan-Mar.

Abstract

Context: Advent of trastuzumab has brought tremendous changes in the survival of human epidermal growth factor receptor 2 (Her2)-positive breast cancer patients. Despite the availability of the drug, it is still out of reach for many patients. There is very limited real world data regarding treatment challenges and survival analysis of these patients.

Aims and objectives: Primary objective is disease-free survival (DFS) and secondary objective is overall survival (OS) and toxicity profile.

Statistics: Statistical analysis is done using GraphPad Prism 7.02.

Materials and methods: This is a retrospective study of all patients diagnosed with Her2-positive (Her2+) nonmetastatic invasive breast cancer from January 2007 to December 2013.

Results: In the period of this study, 885 patients are diagnosed with carcinoma breast, of which 212 are Her2/neu positive (23.9%). Of the 212 patients, only 76 (35.8%) patients received trastuzumab along with chemotherapy. Patients receiving trastuzumab with chemotherapy have longer 5-year DFS compared to those receiving chemotherapy alone, 92% and 52.6%, respectively (P = 0.0001). Five-year OS is 90.5% and 41.7% in those patients who received chemotherapy with and without trastuzumab, respectively (P = 0.0001). Seven patients (9.45%) developed Grade II reversible diastolic dysfunction. Grade II/III peripheral neuropathy due to paclitaxel is the main adverse effect seen in 21 patients.

Conclusion: In spite of improvement in DFS and OS with trastuzumab, the number of patient receiving targeted therapy is very low due to financial constraints which need to be addressed to bridge the gap in survival of Her2+ patients.

Keywords: Breast cancer; India; human epidermal growth factor receptor 2-positive; real world.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of treatment schema of all human epidermal growth factor receptor 2-positive patients
Figure 2
Figure 2
Five-year disease-free survival of all human epidermal growth factor receptor 2-positive patients
Figure 3
Figure 3
Five-year disease-free survival in Stage II
Figure 4
Figure 4
Five-year disease-free survival in Stage III
Figure 5
Figure 5
Five-year overall survival of all human epidermal growth factor receptor 2-positive patients
See this image and copyright information in PMC

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