Neoadjuvant treatment strategies for HER2-positive breast cancer: cost-effectiveness and quality of life outcomes

2020 ◽  
Vol 181 (1) ◽  
pp. 43-51 ◽  
Author(s):  
M. J. Hassett ◽  
H. Li ◽  
H. J. Burstein ◽  
R. S. Punglia
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cost Effectiveness ◽  
Neoadjuvant Treatment ◽  
Treatment Strategies ◽  
Life Outcomes ◽  
Her2 Positive ◽  
Cancer Cost ◽  
Positive Breast Cancer

scholarly journals Cost-Effectiveness of Neoadjuvant-Adjuvant Treatment Strategies for Women With ERBB2 (HER2)–Positive Breast Cancer

2020 ◽  
Vol 3 (11) ◽  
pp. e2027074
Author(s):  
Natalia Kunst ◽  
Shi-Yi Wang ◽  
Annette Hood ◽  
Sarah S. Mougalian ◽  
Michael P. DiGiovanna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Adjuvant Treatment ◽  
Treatment Strategies ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

Health-related quality of life in the Swedish PREDIX HER2 trial, evaluating docetaxel, trastuzumab, pertuzumab versus trastuzumab emtansine as neoadjuvant treatment of HER2-positive breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 583-583 ◽  
Author(s):  
Yvonne Brandberg ◽  
Anne Andersson ◽  
Judith Bjohle ◽  
Ana Bosch ◽  
Lena Carlsson ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Trastuzumab Emtansine ◽  
Her2 Positive ◽  
Related Quality ◽  
Eortc Qlq C30 ◽  
Health Related ◽  
Eortc Qlq ◽  
Positive Breast Cancer

583 Background: Neoadjuvant therapy combining docetaxel, trastuzumab and pertuzumab (DTP) was compared to trastuzumab emtansine (T-DM1) in the randomized phase 2 PREDIX HER2 trial. Patients, ≥18 years with HER2 positive breast cancer, ≥20mm or with verified lymph node metastases, were randomized to six courses of DTP (Standard arm) or T-DM1 (Experimental arm). Primary endpoint was pathological objective response to primary medical therapy at post-treatment surgery. Health related quality of life (HRQoL) was a secondary outcome, and is of specific interest as there was no difference between the randomization groups regarding the main endpoint (results presented in a separate abstract sent to ASCO 2019, Bergh et al.). Methods: Of 202 randomized patients, 190 are available for evaluation at this point. HRQoL was measured, using EORTC QLQ-C30 + EORTC QLQ-BR23, at baseline before randomization and after six courses. Results: No differences between the randomization arms were found at baseline. Results after six courses, based on 163 patients (86%) and adjusted to baseline values, revealed statistical significant differences (p≤0.01), favoring the experimental T-DM1 arm on 7 out of 15 of the EORTC QLQ-C30 variables (Physical functioning, Role functioning, Social functioning, Global quality of Life, Fatigue, Dyspnea, and Diarrhea). For the breast cancer specific questionnaire (EORTC-BR23), the experimental arm scored statistically significantly better on 5 out of 7 subscales (Body image, Sexual functioning, Sexual enjoyment, Systemic therapy side effects and Upset by hair loss). All of the statistical significant differences were of moderate or large clinical significance (≥10 scale scores). No differences between the randomization arms were found for the remaining HRQoL variables. Conclusions: The experimental arm reported better HRQoL than the control arm after six courses. Trastuzumab emtansine may be a useful treatment alternative due to better HRQoL and lower toxicity. Clinical trial information: NCT02568839.

scholarly journals Immune Checkpoint Blockade in HER2-Positive Breast Cancer: What Role in Early Disease Setting?

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1655
Author(s):  
Cinzia Solinas ◽  
Debora Fumagalli ◽  
Maria Vittoria Dieci
Keyword(s):  
Breast Cancer ◽  
Immune Checkpoint ◽  
Neoadjuvant Treatment ◽  
Tumor Infiltrating Lymphocytes ◽  
Immune Checkpoint Blockade ◽  
Checkpoint Blockade ◽  
Current Evidence ◽  
Her2 Positive ◽  
Her2 Positive Breast Cancer ◽  
Positive Breast Cancer

The present commentary synthesizes the current evidence on the role of the immune response in HER2-positive breast cancer. It points out the strengths and weaknesses of the findings observed so far, particularly in the early setting, including the clinical significance of scoring tumor-infiltrating lymphocytes. A figure proposing research hypotheses for the implementation of immune checkpoint blockade use for patient candidates to neoadjuvant treatment is presented.

Efficacy and safety of neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCH-P) in HER2-positive breast cancer: An Indian experience.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12619-e12619
Author(s):  
Ajay Gogia ◽  
Shalabh Arora ◽  
SVS Deo ◽  
Sandeep Mathur ◽  
Dayanand Sharma
Keyword(s):  
Breast Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Breast Conservation ◽  
Radical Mastectomy ◽  
Stage Ii ◽  
Breast Conservation Surgery ◽  
Secondary Outcome ◽  
Her2 Positive ◽  
Positive Breast Cancer

e12619 Background: Dual targeted therapy with chemotherapy is one of the therapeutic approaches as neoadjuvant treatment in HER2/neu positive breast cancer (BC). However the safety and efficacy data of dual-targeted, chemotherapy regimen (docetaxel, carboplatin, trastuzumab, & pertuzumab [TCH-P] is limited from the Indian subcontinent. Methods: This retrospective study aims to evaluate the efficacy and toxicity of neoadjuvant TCH-P regimen in early, locally advanced, and oligometastatic (OM) HER2-positive BC, at All India Institute of Medical Sciences, New Delhi, India, in between the period 2015-2020. Total 6 cycles of 3-weekly neoadjuvant chemotherapy (NACT) protocol containing docetaxel (75 mg/m2), carboplatin (AUC = 6), trastuzumab (8 mg/kg loading followed by 6 mg/kg) and pertuzumab ( 840 mg loading followed by 420 mg) were planned. Subcutaneous peg-filgrastim was prophylactically administered on day 2 of each cycle. The primary outcome was the pathological complete response (pCR), which was defined as an absence of invasive and noninvasive cancer in breast or lymph node and secondary outcome were clinical overall response rate (ORR), rate of breast conservation surgery( BCS) for patients for whom modified radical mastectomy( MRM)was planned and toxicity. Results: Forty-five patients with a median age of 48 years (31-65) were included in this study. The TNM (AJCC-7th edition) stage distribution was stage II, 14 (31.1%); stage III, 29 (64.5%); and stage IV (OM), 2 (4.4%). Clinical node positivity disease was found in 26 (57.8%) cases. Nineteen (42.2%) patients had hormone-positive and 26(57.8%) cases were premenopausal. The clinically ORR and CR were seen in 100% and 60% respectively. Overall pCR rate was observed in 25 (55.6%) patients (70% in stage II). BCS was performed in 23(51.1%) cases. In 12(26.6%) cases, planned MRM was changed to BCS following NACT. Grade 3 and 4 toxicities were diarrhea 7 cases, thrombocytopenia in 6, neutropenia in 4, febrile neutropenia in 1, and anemia in 2 cases. Ten patients required dose modification and interruption. No patient had congestive heart failure or induction death. Conclusions: This is the first study of the non-anthracycline-based neoadjuvant protocol in HER2 positive BC from India. The TCH-P is an effective, safe, and well-tolerated, protocol with a path CR rate of 55.6% and 26.6% BCS conversion rate from planned MRM.

scholarly journals Key Factors Contributing to Quality of Life for Breast Cancer Patients in Latvia: Supplementing Quantitative Surveys with Qualitative Interviews

2012 ◽  
Vol 12 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Agnese Dzērvīte ◽  
Maruta Pranka ◽  
Tana Lace ◽  
Ritma Rungule ◽  
Edvins Miklasevics ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cancer Patients ◽  
Qualitative Interviews ◽  
Treatment Strategies ◽  
Well Being ◽  
University Hospital ◽  
Breast Cancer Patients ◽  
Key Factors

Summary Introduction. Health related quality of life is a much debated topic in medicine with much quantitative and qualitative research contributing to the understanding of how to improve the lives of patients, yet little has been published in relation to the quality of life of Latvian breast cancer patients. Aim of the Study. To gather base measurements of subjective and objective quality of life factors for breast cancer patients in Latvia and discover which key factors contribute most to quality of life of Latvian breast cancer patients at the start of treatment. Materials and Methods. This paper presents data collected from April 2010 to June 2011 at the Pauls Stradins Clinical University hospital on key factors influencing quality of life for breast cancer patients: health and physical well-being; state of surroundings and environment; social support and functionality; financial state, employment and leisure. Quantitative survey material has been supplemented with insight from qualitative in-depth interviews to better explain the objective and subjective implications for breast cancer patients’ quality of life. Results. Interviewed breast cancer patients rated their quality of life as being average or good at the beginning of treatment. Negative factors contributing to lowered quality of life were mainly linked to patient financial, social and emotional state at the first weeks of treatment and correspond to previous research done in Latvia on quality of life issues. Conclusions. Further follow-up surveys will contribute to the evaluation of breast cancer patients’ needs while undergoing treatment to further improve treatment strategies, especially if validated quality of life measurement surveys were to be implemented in Latvian hospitals.

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