Rahardja Sylwan, Tan Ryan Ying Cong, Sultana Rehena, Leong Fun Loon, Lim Elaine Hsuen
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
National Cancer Centre Singapore, Singapore 169610, Singapore.
World J Clin Oncol. 2020 Mar 24;11(3):143-151. doi: 10.5306/wjco.v11.i3.143.
Pertuzumab is a humanized anti-human epidermal growth factor receptor 2 (HER2) monoclonal antibody found in a Phase III clinical trial to significantly improve median survival in HER2 positive metastatic breast cancer (MBC) when used in combination with a taxane and Trastuzumab, and its clinical efficacy has transformed the therapeutic landscape of HER2-positive breast cancer. There are currently few reports on the pattern of use and value of Pertuzumab in real world settings. Our study describes the clinical efficacy and treatment costs of Pertuzumab in HER2-positive MBC treated in a tertiary cancer centre in Singapore in a predominantly Asian population.
To investigate the clinical efficacy and treatment costs of Pertuzumab in HER2-positive MBC in an Asian population in Singapore.
A retrospective study of 304 HER2-positive MBC patients seen at National Cancer Centre Singapore between 2011-2017 was conducted. Demographic and clinical data were extracted from electronic medical records. Clinical characteristics and billing data of patients who received Pertuzumab were compared with those who did not.
Thirty-one (62.0%) of the fifty (16.4%) patients who received Pertuzumab as first-line therapy. With a median follow-up of 21.5 mo, there was a statistically significant difference in the median overall survival between Pertuzumab and non-Pertuzumab groups [51.5 (95%CI: 35.8-60.0) 32.9 (95%CI: 28.1-37.5) mo; 0.0128]. Two (4.88%) patients in the Pertuzumab group experienced grade 3 (G3) cardiotoxicity. The median treatment cost incurred for total chemotherapy for the Pertuzumab group was 130456 Singapore Dollars compared to 34523 Singapore Dollars for the non-Pertuzumab group. The median percentage of total chemotherapy costs per patient in the Pertuzumab group spent on Pertuzumab was 50.3%.
This study shows that Pertuzumab use in the treatment of metastatic breast cancer is associated with a significantly better survival and a low incidence of serious cardiotoxicity. However, the proportionate cost of Pertuzumab therapy remains high and further cost-effectiveness studies should be conducted.
帕妥珠单抗是一种人源化抗人表皮生长因子受体2（HER2）单克隆抗体，在一项III期临床试验中发现，当与紫杉烷和曲妥珠单抗联合使用时，可显著提高HER2阳性转移性乳腺癌（MBC）的中位生存期，其临床疗效改变了HER2阳性乳腺癌的治疗格局。目前关于帕妥珠单抗在真实世界中的使用模式和价值的报道较少。我们的研究描述了帕妥珠单抗在新加坡一家三级癌症中心治疗的以亚洲人群为主的HER2阳性MBC中的临床疗效和治疗成本。
调查帕妥珠单抗在新加坡亚洲人群HER2阳性MBC中的临床疗效和治疗成本。
对2011年至2017年在新加坡国立癌症中心就诊的304例HER2阳性MBC患者进行回顾性研究。从电子病历中提取人口统计学和临床数据。将接受帕妥珠单抗治疗的患者的临床特征和计费数据与未接受治疗的患者进行比较。
50例（16.4%）接受帕妥珠单抗一线治疗的患者中有31例（62.0%）。中位随访21.5个月，帕妥珠单抗组和非帕妥珠单抗组的中位总生存期存在统计学显著差异[51.5（95%CI：35.8 - 60.0）对32.9（95%CI：28.1 - 37.5）个月；P = 0.0128]。帕妥珠单抗组有2例（4.88%）患者发生3级（G3）心脏毒性。帕妥珠单抗组化疗总费用的中位数为130456新加坡元，而非帕妥珠单抗组为34523新加坡元。帕妥珠单抗组每位患者化疗总费用中用于帕妥珠单抗的中位数百分比为50.3%。
本研究表明，使用帕妥珠单抗治疗转移性乳腺癌可显著提高生存率，且严重心脏毒性发生率较低。然而，帕妥珠单抗治疗的相对成本仍然很高，应进一步开展成本效益研究。
