Ades Felipe, Senterre Christelle, Zardavas Dimitrios, de Azambuja Evandro, Popescu Razvan, Piccart Martine
Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
Centro de Oncologia e Hematologia, Hospital Israelita Albert Einstein, São Paulo, Brazil.
PLoS One. 2017 Mar 14;12(3):e0172351. doi: 10.1371/journal.pone.0172351. eCollection 2017.
The development of trastuzumab is considered to be one of the greatest improvements in breast cancer treatment in recent years. This study aims to evaluate changes in the uptake of trastuzumab over the last 12 years and to determine whether its use is proportional to patient needs in the European Union and the USA.
Using national registry data, the number of new cases of HER2-positive breast cancer patients per year was estimated. The number of likely trastuzumab treatments per year was estimated using trastuzumab procurement data for each country.
Western Europe and the USA show increasing procurement level of trastuzumab over the years studied, reaching proportional of use of trastuzumab few years after its marketing authorization in the early 2000's. After the approval in the adjuvant setting, in the year 2006, it was observed underuse of trastuzumab given the increase of the number of patients in need of treatment. Proportional use was shortly met after a couple of years. Few countries in Eastern Europe acquired the needed quantity of trastuzumab, with procurement levels starting to increase only after approval in the adjuvant setting in 2006.
Significant differences in trastuzumab procurement are observed between Western Europe, the USA and Eastern Europe, with the latter geographic region acquiring insufficient amounts of the drug required to treat all patients in need.
曲妥珠单抗的研发被认为是近年来乳腺癌治疗领域最重大的进展之一。本研究旨在评估过去12年中曲妥珠单抗使用情况的变化，并确定其在欧盟和美国的使用是否与患者需求成正比。
利用国家登记数据，估算每年HER2阳性乳腺癌患者的新发病例数。利用各国曲妥珠单抗采购数据，估算每年可能接受曲妥珠单抗治疗的病例数。
在研究的这些年里，西欧和美国的曲妥珠单抗采购水平不断提高，在21世纪初其上市授权后的几年里达到了曲妥珠单抗的使用比例。在辅助治疗获批后的2006年，鉴于需要治疗的患者数量增加，观察到曲妥珠单抗使用不足。几年后很快达到了使用比例。东欧只有少数国家采购了所需数量的曲妥珠单抗，采购水平直到2006年辅助治疗获批后才开始上升。
西欧、美国和东欧在曲妥珠单抗采购方面存在显著差异，东欧地区获取的治疗所有有需求患者所需药物数量不足。
