Ten years of using adjuvant trastuzumab in breast cancer in Serbia – Single institution experience

JBUON 2018; 23(2): 353-360
ISSN: 1107-0625, online ISSN: 2241-6293 • www.jbuon.com
E-mail: editorial_office@jbuon.com

Authors – Ana Cvetanovic1,2, Sladjana Filipovic1,2, Nikola Zivkovic1,3, Lazar Popovic4, Milos Kostic1, Miodrag Djordjevic5, Aleksandar Karanikolic1,5, Dane Krtinic1,2

1 Medical Faculty, University of Nis, Nis, Serbia; 2 Department of Oncology, University Clinic of Nis, Nis, Serbia; 3 Department of Pathology, University Clinic of Nis, Nis, Serbia; 4 Oncology Institute of Vojvodina, Sremska Kamenica, Serbia and Medical Faculty, University of Novi Sad, Novi Sad, Serbia; 5 Department for Surgery, University Clinic of Nis, Nis, Serbia

Purpose: The purpose of this study was to determinate disease-free interval (DFI) and overall survival (OS) in HER2-positive breast cancer patients who received adju vant trastuzumab at the University Clinic of Nis, Serbia, and to investigate the influence of clinicopathological and
biological characteristics of the tumor on prognosis. The second aim was to determinate the most frequent cause for the treatment discontinuation, recurrence rate, as well as the site of most common localization of the first recurrence of disease.

Methods: This research was conducted as a retrospective study at the University Oncology Clinic, Clinical Centre in Nis. The study included 238 patients who were operated and treated for HER2-positive breast cancer between January 1st, 2007 to September 30th, 2012 and followed up until December 31st, 2016. Trastuzumab was administered concurrently with taxanes, if administered, or after the completed anthracycline-based chemotherapy.


Results: After a median follow up of 69 months the 5-year DFI was 65.9% and 5-year OS was 81.8% and, as expected, significantly longer in the group of patients with smaller tumors, a smaller number of positive axillary lymph nodes, as well as a lower stage of disease (p<0.0001). Patients older than 65 years had a longer DFI compared to the 45-65 and under 45 age groups of patients (p=0.01). No statistical significance was found in the length of DFI in relation to the histological tumor subtype, tumor grade, or the status of hor mone receptors. Unlike DFI, a longer OS was recorded in the group of patients with lower tumor grade (p=0.03) and there was no statistically significant difference in survival regarding the age of patients (p=0.07). Recurrence occurred in ap proximately one third of the patients (38.23%), mostly in the form of local recurrence. Adjuvant therapy with trastuzum ab was not completely carried out in 18.49% of the patients,the most common reason being the progression of disease.

Conclusions: A long median follow up period of 69 months indicated that anti-HER2 monoclonal antibody trastuzumab, after anthracycline-based chemotherapy or concurrently with taxanes, is efficient and safe in treating early breast cancer.

Key words: adjuvant trastuzumab, disease free interval,overall survival

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