Assessing the Real‐World Cost‐Effectiveness of Adjuvant Trastuzumab in HER‐2/neu Positive Breast Cancer

Abstract Background Trastuzumab emtansine (T-DM1) is a second-line standard therapy for patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. Evidence regarding post–T-DM1 treatments is currently lacking. We evaluated the effectiveness of post–T-DM1 drug therapy in patients with HER2-positive, unresectable and/or metastatic breast cancer. Methods In this multicenter, retrospective, observational study, real-world clinical data of female patients with HER2-positive breast cancer who had a history of T-DM1 treatment were consecutively collected from five sites in Japan. We investigated the effectiveness of post–T-DM1 therapy by evaluating the real-world progression-free survival (rwPFS), time to treatment failure (TTF), overall survival (OS), objective response rate (ORR), and clinical benefit rate (CBR). Tumor response was assessed by investigators according to Response Evaluation Criteria in Solid Tumors (RECIST version 1.1) guidelines. Subgroup and exploratory analyses according to background factors were also undertaken. Results Of the 205 patients who received T-DM1 treatment between 1 January 2014 and 31 December 2018, 128 were included in this study. Among the 128 patients analyzed, 105 (82%) patients received anti-HER2 therapy and 23 (18%) patients received regimens without anti-HER2 therapy. Median (95% confidence interval [CI]) rwPFS, TTF, and OS were 5.7 (4.8–6.9) months, 5.6 (4.6–6.4) months, and 22.8 (18.2–32.4) months, respectively. CBR and ORR (95% CI) were 48% (38.8–56.7) and 23% (15.1–31.4), respectively. Cox-regression analysis showed that an ECOG PS score of 0, a HER2 immunohistochemistry score of 3+, recurrent type, ≥12 month duration of T-DM1 therapy, and anti-HER2 therapy were independent variables for rwPFS. An exploratory subgroup analysis of regimens after T-DM1 showed that those with anti-HER2 therapy had a median rwPFS of 6.3 and those without anti-HER2 therapy had a median rwPFS of 4.8 months. Conclusions In the real-world setting in Japan, several post–T-DM1 regimens for patients with unresectable and/or metastatic HER2-positive breast cancer, including continuation of anti-HER2 therapy, showed some effectiveness; however, this effectiveness was insufficient. Novel therapeutic options are still needed for further improvement of PFS and OS in later treatment settings. Trial registration UMIN000038296; registered on 15 October 2019.

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Abstract PS10-58: Cost effectiveness of routine cardiac imaging during adjuvant trastuzumab in HER2-positive breast cancer

10.1158/1538-7445.sabcs20-ps10-58 ◽

2021 ◽

Author(s):

Vineeth Tatineni ◽

Daniel Redle ◽

Daljeet Singh ◽

Arifa Abid ◽

Sameer Mahesh

Keyword(s):

Breast Cancer ◽

Cost Effectiveness ◽

Cardiac Imaging ◽

Her2 Positive ◽

Adjuvant Trastuzumab ◽

Her2 Positive Breast Cancer ◽

Positive Breast Cancer

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Real world data of trastuzumab in the treatment of early stage HER- 2 positive breast cancer in southern of Brazil

The Breast ◽

10.1016/s0960-9776(19)30223-1 ◽

2019 ◽

Vol 44 ◽

pp. S56

Author(s):

T. Belladona Cardoso ◽

J.D. Lyra Batista ◽

R.J. Vargas Alves ◽

K. Arima Tiscoski ◽

F. Pontes Grando

Keyword(s):

Breast Cancer ◽

Real World ◽

Early Stage ◽

Real World Data ◽

World Data ◽

Her 2 ◽

Positive Breast Cancer

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Real-World Setting Cost-Effectiveness Analysis Comparing Three Therapeutic Schemes of One-Year Adjuvant Trastuzumab in HER2-Positive Early Breast Cancer from the Cyprus NHS Payer Perspective

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17124339 ◽

2020 ◽

Vol 17 (12) ◽

pp. 4339

Author(s):

Savvas S. Ioannou ◽

Yiola Marcou ◽

Eleni Kakouri ◽

Michael A. Talias

Keyword(s):

Breast Cancer ◽

Cost Effectiveness ◽

Early Breast Cancer ◽

Real World ◽

Cost Effective ◽

Her2 Positive ◽

Adjuvant Trastuzumab ◽

Lifetime Horizon ◽

Effectiveness Analysis ◽

One Year

Introduction: This study is one of the first real-world cost-effectiveness analyses of one-year adjuvant trastuzumab used in HER2-positive early female breast cancer in comparison to chemotherapy alone. It is just the second one in Europe, the first one in Cyprus, and the fourth one worldwide ever carried out using real-world data. Methods: Using a Markov model (four health states), a cost-effectiveness analysis was carried out both over 20 years and for a lifetime horizon. The sampling method used in this study was the randomized sampling of 900 women. Results: The findings for the 20-year horizon showed that all trastuzumab arms were more cost-effective, with a willingness-to-pay threshold of only €60,000 per quality-adjusted life year (QALY) [incremental cost-effectiveness ratios (ICER): €40,436.10/QALY]. For the lifetime horizon, with thresholds of €20,000, €40,000, and €60,000/QALY, all trastuzumab arms were found to be more cost-effective (ICER: €17,753.85/QALY). Moreover, for the 20-year and the lifetime horizons, with thresholds of €20,000/QALY, €40,000/QALY, and €60,000/QALY, the most cost-effective of the three subgroups (anthracyclines and then trastuzumab, no anthracyclines and then trastuzumab, and anthracyclines, taxanes, and trastuzumab) was that of anthracyclines and then trastuzumab (ICER: €18,301.55/QALY and €8954.97/QALY, respectively). Conclusions: The study revealed that adjuvant trastuzumab for one year in female HER2-positive early breast cancer can be considered cost-effective.

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