title: Non-initiation and early discontinuation of adjuvant trastuzumab in women with localized HER2-positive breast cancer.
abstract: One year of trastuzumab therapy is recommended for women with HER2-positive breast cancer ≥ 1.0 cm in size to increase survival and is considered for women with tumors 0.5-0.9 cm in size. We analyzed compliance with trastuzumab among women with HER2-positive breast cancer in a prospective cohort study. Of 1145 recruited patients with breast cancer, 152 were HER2-positive (13.2 %), of whom 126 had tumors ≥ 1.0 cm; 110/126 (87.3 %) of these initiated trastuzumab. Non-receipt was associated with older age, better prognosis tumors, and with non-receipt of adjuvant chemotherapy. Of the 110 who initiated treatment, 18 (15 %) did not complete treatment, 15 (83 %) of them because of cardiotoxicity. Of 20 women with tumors 0.5-0.9 cm, 5 (25 %) initiated trastuzumab. Compliance with trastuzumab was very high among those with HER2-positive breast cancer, as was the completion of the recommended therapy.
authors.affiliation: Department of Medicine, Columbia University, New York, NY, USA, ain1@columbia.edu.
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
authors.forename: Grace Clarke
authors.initials: GC
authors.lastname: Hillyer
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.forename: Lois
authors.initials: L
authors.lastname: Lamerato
authors.forename: Nicole
authors.initials: N
authors.lastname: Leoce
authors.forename: Christine B
authors.initials: CB
authors.lastname: Ambrosone
authors.forename: Dana H
authors.initials: DH
authors.lastname: Bovbjerg
authors.forename: Jeanne S
authors.initials: JS
authors.lastname: Mandelblatt
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D005260:Female; D006801:Humans; D055118:Medication Adherence; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D000068878:Trastuzumab; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human