Guideline Concordant Therapy Prolongs Survival in HER2-Positive Breast Cancer Patients: Results from a Large Population-Based Cohort of a Cancer Registry

Abstract

Even though randomized controlled clinical trials demonstrated improved survival by adjuvant trastuzumab treatment of HER2-positive breast cancer patients, data on its effect in clinical routine are scarce. This study evaluated the use and efficacy of trastuzumab in routine treatment of HER2-positive breast cancer patients. Data from the clinical cancer registry Regensburg (Germany) were analyzed. The present study investigated 6,991 female patients with primary invasive breast cancer. In premenopausal HER2-positive patients a considerable increase of trastuzumab therapy was observed from 58.1% in 2006 to 90.9% in 2011, whereas in postmenopausal patients trastuzumab was rather used on a constant rate of 49.1%. Best overall survival (OS) was found in HER2/steroid hormone receptor-positive patients receiving guideline concordant treatment with trastuzumab plus chemotherapy (CHT) plus antihormone therapy (AHT) with a 7-year OS rate of 96% compared to the non-trastuzumab group with a 7-year OS rate of 92%. In multivariable analysis, HER2-positive patients treated with CHT or AHT who did not get trastuzumab, had a worse 7-year OS (65%, P = 0.006 versus 79%, P = 0.017) than the control groups. This population-based study demonstrated that guideline concordant use of adjuvant trastuzumab improves OS for HER2-positive breast cancer patients treated in routine clinical care.

Adherence to granulocyte-colony stimulating factor (G-CSF) guidelines to reduce the incidence of febrile neutropenia after chemotherapy—a representative sample survey in Germany

“…It is known that adherence to guidelines in cancer therapy improves survival [5,17]. Also, the use of G-CSF can improve the treatment result through fewer complications and better maintenance of the dose intensity [22,27].…”

4-IHC classification of breast cancer subtypes in a large cohort of a clinical cancer registry: use in clinical routine for therapeutic decisions and its effect on survival

“…Patient data originate from the University Hospital Regensburg, 53 regional hospitals, and more than 1000 practicing doctors. On the basis of medical reports, pathology, and follow-up records, the population-based data were routinely documented in each case [ 10 ].…”

“…Immuno-histochemical determination of 4-IHC was performed consistent with defined standards as described in detail in previous studies of our group [ 10 – 12 ].…”

Identifying clinical practice guidelines for the supportive care of children with cancer: A report from the Children's Oncology Group

“…[3][4][5] Across diverse clinical domains, delivering care consistent with clinical practice guideline (CPG) recommendations improves outcomes. [6][7][8][9][10] As such, provision of evidence-based supportive care to children with cancer has the potential to optimize treatment outcomes and improve quality of life.…”