Otoya Iris, Valdiviezo Natalia, Morante Zaida, Calle Cindy, Ferreyra Yomali, Huarcaya-Chombo Norma, Polo-Mendoza Gabriela, Castañeda Carlos, Vidaurre Tatiana, Neciosup Silvia P, Calderón Mónica J, Gomez Henry L
Department of Medical Oncology Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru.
Department of Bioengineering Universidad de Ingeniería y Tecnología, Lima, Peru.
Int J Breast Cancer. 2024 Jun 22;2024:9551710. doi: 10.1155/2024/9551710. eCollection 2024.
In Peru, breast cancer (BC) stands as the most predominant malignancy neoplasm among women. Trastuzumab has marked a significant milestone in the management of this disease. It has been shown to improve prognosis in human epidermal growth factor receptor 2 (HER2)-expressing female patients, but its repercussions and efficacy are yet to be analyzed in a context with limited resources. The study population is made of woman patients aged 18 years and older diagnosed with HER2-positive BC at Instituto Nacional de Enfermedades Neoplásicas (INEN, Lima, Peru) during 2019-2021 and treated with at least one dose of subcutaneous trastuzumab. We reviewed medical records to register treatment characteristics, adverse events (AEs), disease progression, and survival status. We considered a median follow-up time of 36 and 45 months for progression and survival status. The majority of patients were over 50 years old (54.29%). Tumor size averaged 19.7 ± 16.1 mm. Lymph nodes were present in 44.78% of patients. Most patients received adjuvant chemotherapy (63.8%) as first-line treatment. Descriptive analyses of treatment outcomes revealed a 30% toxicity rate, primarily attributed to arthralgia (47.62%), followed by diarrhea, fatigue, and injection site reactions, with relatively lower discontinuation rates compared to larger scale studies. Differences in demographic, clinical, and treatment characteristics were not statistically significant concerning the emergence of AEs ( > 0.05). Progression appeared in nine patients, and the overall survival (OS) rate stood at 98.6% and 92.8%, respectively, during a median follow-up of 36 and 45 months. The research suggests that subcutaneous trastuzumab is comparable in effectiveness and safety to the intravenous administration. Regional-specific studies may provide valuable insights into demographic factors influencing treatment outcomes in Peru or other countries. Furthermore, it could represent a more accessible alternative, potentially enhancing patient adherence and optimizing healthcare resource logistics.
在秘鲁,乳腺癌是女性中最主要的恶性肿瘤。曲妥珠单抗在该疾病的治疗中具有重要意义。已证实它能改善人表皮生长因子受体2(HER2)阳性女性患者的预后,但在资源有限的情况下,其影响和疗效仍有待分析。研究对象为2019年至2021年期间在秘鲁利马国立肿瘤疾病研究所(INEN)被诊断为HER2阳性乳腺癌且接受过至少一剂皮下曲妥珠单抗治疗的18岁及以上女性患者。我们查阅医疗记录以登记治疗特征、不良事件(AE)、疾病进展和生存状况。对于进展和生存状况,我们考虑的中位随访时间分别为36个月和45个月。大多数患者年龄超过50岁(54.29%)。肿瘤大小平均为19.7±16.1毫米。44.78%的患者有淋巴结转移。大多数患者接受辅助化疗(63.8%)作为一线治疗。治疗结果的描述性分析显示毒性率为30%,主要归因于关节痛(47.62%),其次是腹泻、疲劳和注射部位反应,与大规模研究相比停药率相对较低。不良事件的出现与人口统计学、临床和治疗特征的差异无统计学意义(P>0.05)。9例患者出现疾病进展,在中位随访36个月和45个月时,总生存率(OS)分别为98.6%和92.8%。研究表明,皮下曲妥珠单抗在有效性和安全性方面与静脉给药相当。针对特定地区的研究可能为影响秘鲁或其他国家治疗结果的人口统计学因素提供有价值的见解。此外,它可能是一种更容易获得的选择,有可能提高患者的依从性并优化医疗资源配置。