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. 2025 Aug:11:e2400612.
doi: 10.1200/GO-24-00612. Epub 2025 Aug 7.

Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in Tanzania

Lemi Ndugumbi Zinga  1 , Queen Godfrey Tarimo  1 , Kelvin Mbelekwa  1 , Mamsau Twalib Ngoma  1   2 , Emmanuel L Lugina  1   2
Affiliations

Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in Tanzania

Lemi Ndugumbi Zinga et al. JCO Glob Oncol. 2025 Aug.

Abstract

Purpose: Human epidermal growth factor receptor 2 (HER2)-positive breast cancer (HER2+BC) is linked to poorer outcomes. Trastuzumab is the standard treatment, but its high cost limits access in resource-limited settings. This study evaluated the treatment patterns and survival outcomes of patients with HER2 BC in Tanzania.

Materials and methods: A retrospective hospital-based study was conducted between January 2018 and May 2021 at two prominent public tertiary hospitals in Tanzania. The primary outcome was the 5-year overall survival (OS) rate. Independent variables included demographics, clinical characteristics, and treatment patterns. Survival analysis was conducted using the Kaplan-Meier method. The log-rank test was used in univariate analysis, whereas multivariate Cox regression was used in multivariate analysis.

Results: A total of 169 patients with nonmetastatic HER2+BC were included, with a median age of 50 years. Most patients were estrogen receptor-positive (50.3%) and diagnosed with stage III BC (58.6%). About 70.4% of patients received trastuzumab, whereas neoadjuvant chemotherapy was administered to 24.3%, and 95.9% underwent mastectomy. Trastuzumab was primarily used in the adjuvant setting rather than the neoadjuvant setting and was more accessible to patients with higher socioeconomic status. The 5-year OS was 65%, with a median survival of 72 months. Trastuzumab reduced the mortality risk by 74%. Extended therapy with trastuzumab benefited patients with hormone receptor-negative HER2+BC more than those who were hormone receptor-positive. Advanced-stage disease increased mortality risk, whereas postmenopausal status and nonsmoking were associated with lower mortality. A higher Eastern Cooperative Oncology Group score (>1) was associated with an increased mortality risk.

Conclusion: Trastuzumab significantly improves OS in resource-limited settings, particularly in patients with hormone receptor-negative HER2+BC. There are disparities in access to trastuzumab in Tanzania.

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Conflict of interest statement

The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated unless otherwise noted. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/go/authors/author-center.

Open Payments is a public database containing information reported by companies about payments made to US-licensed physicians (Open Payments).

No potential conflicts of interest were reported.

References

    1. Patel A, Unni N, Peng Y. The changing paradigm for the treatment of HER2-positive breast cancer. Cancers (Basel) 2020;12:1–17. - PMC - PubMed
    1. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA A Cancer J Clin. 2015;65:87–108. - PubMed
    1. World Health Organisation . Access to Medicines, Vaccines and Pharmaceuticals—Technical Report—Pricing of Cancer Medicines and Its Impacts. WHO Press; 2018. pp. 1–171.
    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71:209–249. - PubMed
    1. Shaath H, Elango R, Alajez NM. Molecular classification of breast cancer utilizing long non-coding RNA (lncRNA) transcriptomes identifies novel diagnostic lncRNA panel for triple-negative breast cancer. Cancers (Basel) 2021;13:5350. - PMC - PubMed