Papadmitriou K, Trinh X B, Altintas S, Van Dam P A, Huizing M T, Tjalma W A A
Antwerp University Hospital and University of Antwerp, University Multidisciplinary Breast Clinic and Gynecological Oncology Unit, Wilrijkstraat 10, 2650 Edegem, Belgium.
Facts Views Vis Obgyn. 2015;7(3):176-80.
Trastuzumab was the first targeted therapy for HER2 positive breast cancer. It has become the standard of care for HER2 positive metastatic breast cancer since 2000 and in the adjuvant setting since 2006. Adjuvant it is given for a year and in patients with metastatic disease until progression. The standard mode of administration is intravenous. Recently a subcutaneous form has become available. A phase III study showed that there is no difference between the intravenous and subcutaneous form in terms of safety and efficacy. The patient's preference however significantly favoured the subcutaneous form. It is estimated that the use of the SC form could contribute to a cost saving between 758 and 2576 euro per annual course. For Belgium alone this could mean an estimated saving of 1.4 to 4.6 million euros per year. The potential benefit of the SC administration for healthcare facilities could be further increased when applied in a LEAN working day-care chemotherapy unit. After reviewing the existing literature we suggest to further validate the potential financial impact of SC trastuzumab compared to the traditional IV form and to introduce a scientific proposal incorporating the benefits of this formulation in a LEAN working healthcare unit.
曲妥珠单抗是首个用于治疗HER2阳性乳腺癌的靶向疗法。自2000年起，它已成为HER2阳性转移性乳腺癌的标准治疗方案，自2006年起用于辅助治疗。辅助治疗时给药一年，转移性疾病患者则持续给药直至病情进展。标准给药方式为静脉注射。最近，皮下注射剂型已上市。一项III期研究表明，静脉注射剂型和皮下注射剂型在安全性和疗效方面并无差异。然而，患者明显更倾向于皮下注射剂型。据估计，使用皮下注射剂型每年每个疗程可节省758至2576欧元。仅对比利时而言，这意味着每年估计可节省140万至460万欧元。在精益工作日化疗单元应用时，皮下注射给药对医疗机构的潜在益处可能会进一步增加。在回顾现有文献后，我们建议进一步验证皮下注射曲妥珠单抗与传统静脉注射剂型相比的潜在财务影响，并提出一项科学建议，将该剂型的益处纳入精益工作的医疗单元。
