Poster Presentation Joint 2016 COSA and ANZBCTG Annual Scientific Meeting

Trastuzumab in HER2 positive early breast cancer: A retrospective audit in a regional cancer centre (#321)

Sharon Heng 1 , Khageshwor Pokharel 1 , Peter Gilbar 1 , Margot Tannock 1
  1. Medical Oncology Department, Toowoomba Base Hospital, Toowoomba, QLD, Australia

Aim: To review the usage of Trastuzumab and management of its complications in HER2 positive early breast cancer (EBC) in a regional centre.

Methods: A retrospective clinical chart review was performed on all patients with HER2 positive EBC treated at Toowoomba Base Hospital between September 2010 and June 2016.  

Results: 51 patients with HER2 positive EBC were identified. All were female. More than half (51%) lived further than 100 km away from the hospital, the furthest being 617 km. Axillary lymph nodes were involved in 19 (37.3%) women. All women were offered adjuvant therapy. Only one declined. The majority, 42 (82.4%), received adjuvant therapy less than 8 weeks post-surgery. The preferred regimes were Docetaxel-Carboplatin-Trastuzumab (TCH) and Doxorubicin-Cyclophosphamide-Docetaxel-Trastuzumab (ACTH) administered to 22 (43.1%) and 17 (33.3%) women respectively. 3-weekly Trastuzumab was planned for 17 cycles (52 weeks). All women receiving Trastuzumab had regular echocardiograms. Six (11.8%) women had Trastuzumab-related cardiomyopathy. Five of these women were on an anthracycline-containing chemotherapy regimen. One other woman was on TCH. Delays in administration of Trastuzumab due to cardiomyopathy ranged from three to 16 weeks. One woman ceased Trastuzumab prematurely due to persistent cardiomyopathy. There was specialist cardiology involvement with four of these six women. Approximately eight (15.7%) women had local or distant recurrences. Three occured while on Trastuzumab.

Conclusion: Usage of Trastuzumab and management of Trastuzumab-related cardiomyopathy were in line with recommended international guidelines. The incidence of Trastuzumab-related cardiomyopathy was higher than larger studies and the risk increased with an anthracycline-based chemotherapy regime. There were no issues with compliance due to travel distance.