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Year : 2020  |  Volume : 3  |  Issue : 1  |  Page : 69-73

Short-course adjuvant trastuzumab in breast cancer: Experience from a tertiary cancer center in rural India

1 Department of Clinical Hematology and Medical Oncology, Malabar Cancer Centre, Kannur, Kerala, India
2 Department of Radiation Oncology, Malabar Cancer Centre, Kannur, Kerala, India
3 Department of Surgical Oncology, Malabar Cancer Centre, Kannur, Kerala, India

Correspondence Address:
Praveen Kumar Shenoy
Department of Clinical Hematology and Medical Oncology, Malabar Cancer Centre, Thalassery, Kannur - 670 103, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/CRST.CRST_110_19

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Introduction: Majority of the patients in low-to-middle income countries (LMICs) have no access to adjuvant trastuzumab due to financial constraints. Short-course (9 weeks) schedule of trastuzumab is a feasible alternative in this setting. The objective of this study was to assess the feasibility and outcomes of adjuvant short-course trastuzumab in patients with breast cancer treated at our center. Materials and Methods: This was a retrospective study conducted in a tertiary cancer center in South India. Case records of all patients who received short-course (9 weeks) adjuvant trastuzumab from June 2014 to December 2016 were reviewed. Baseline characteristics, treatment details, and outcomes were analyzed. Results: During the study, 129 patients received short-course trastuzumab. The median age was 50 years (range, 30–74 years). Majority of the patients were postmenopausal (64%). The most common histology was infiltrating ductal carcinoma; 57% had Grade 2 disease. The most common chemotherapy regimen used was doxorubicin + cyclophosphamide (AC), followed by weekly paclitaxel (n = 110, 86%) and docetaxel + cyclophosphamide (TC) (n = 17, 13%). Majority of the patients (n = 120, 93%) had T1 or T2 disease and were node-negative (n = 62, 57%). Sixty-two patients (48%) had hormone receptor-positive disease. One hundred and eight patients (84%) underwent modified radical mastectomy, and the rest had breast conservation surgery. At a median follow-up of 29 months, the 3-year overall survival (OS) was 98%; the median OS was not reached. The 3-year disease-free survival (DFS) was 97.4%; the median DFS was not reached. The regimen was well tolerated and none of the patients developed symptomatic cardiac failure. Conclusions: Our study shows that a 9-week short course of trastuzumab is a feasible strategy in a resource-limited setting and can lead to promising outcomes, especially in early breast cancer.

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