In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 31, No. 15_suppl ( 2013-05-20), p. e11609-e11609
Abstract:
e11609 Background: Anthracyclines remain among the most active agents for the treatment of BC. NSABP B-31, NCCTG N9831 and HERA, each employing anthracyclines followed by trastuzumab in adjuvant HER2+ BC, demonstrated significant reduction in the risk of recurrence and improvement in survival . A fourth study, BCIRG-006, compared a non-anthracycline containing regimen, TCH, to an anthracycline based regimen, AC-TH . Both arms had similar overall survival, but there was a higher incidence of cardiac events in patients who received anthracycline. HER2-analyses in randomized adjuvant trials, in the pre-trastuzumab era, comparing anthracycline with non-anthracycline chemotherapy regimens, show that HER2+ BC derives greater benefit from anthracycline use . TOP2A coamplification, which occurs in 35% of HER2-positive patients, has shown a direct association with anthracycline benefit in several studies. We investigate and report, herein, the ways in which community oncologists are currently treating these patients. Methods: All treatment requests for adjuvant trastuzumab were examined, from 2009 through 2012. Chi-square analysis at 0.05α was used to test for interaction of age group to type of treatment. Results: During this span, oncologists requested adjuvant trastuzumab for 121 patients. In 10% (12/121) of patients, adjuvant trastuzumab alone, without chemotherapy and with or without hormonal therapy, was requested. Among patients who also received adjuvant chemotherapy (109), 35% (38/109), received anthracyclines. There was no relationship of anthracycline-usage with BC stage (data not shown) or patient age (Chi Sq p = 0.73). Adjuvant trastuzumab, without chemotherapy, was requested more often for the elderly (20% versus 4%; Chi Sq p = 0.003). Conclusions: Anthracyclines are utilized in adjuvant HER2+ BC in only about a third of patients, regardless of BC stage or patient age. The availability of a reliable, inexpensive, and convenient test to predict which patients are most likely to benefit from anthracyclines, over other options, would be useful. [Table: see text]
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2013.31.15_suppl.e11609
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2013
detail.hit.zdb_id:
2005181-5
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