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Use of trastuzumab as an adjuvant/neoadjuvant therapy in patients with HER2-positive breast cancer in China: The Nvwa study.

Abstract The aim of this study was to understand current trends in trastuzumab use in China as a neoadjuvant/adjuvant therapy for human epidermal growth factor receptor-2 positive (HER2+) breast cancer and identify factors influencing trastuzumab use.This was a retrospective, multicenter, cross-sectional study of patients diagnosed with HER2+ breast cancer (stage I-III), between July 2013 and June 2014, at 155 hospitals in 29 provinces/cities in China. Demographic and clinical data, including tumor characteristics and details of adjuvant/neoadjuvant therapies used, were collected. Data analysis included univariate analysis, multivariate logistic regression, and subgroup analyses.Of 4994 HER2+ patients (mean age 51.1 ± 9.9 years) included, only 29.8% received trastuzumab, with 30.5% in adjuvant therapy and 18.3% in neoadjuvant therapy. The highest rates of adjuvant trastuzumab were in Beijing (59.3%), Jiangsu (57.1%), and Ningxia (50.0%), while those of neoadjuvant trastuzumab were in Guangdong (24.8%), Beijing (14.1%), and Zhejiang (10.7%). Multivariate regression results revealed that factors associated with trastuzumab use were medical insurance cover for trastuzumab, residing locally to the hospital, more lymph node involvement, and more advanced tumor stage. Subgroup analysis revealed that patients receiving neoadjuvant therapy were likely to be younger, premenopausal and non-local, and had lymph node metastases, more advanced tumor, and progesterone receptor positive tumor.Trastuzumab use in patients with HER2+ breast cancer is relatively low in China, especially for neoadjuvant therapy. Insurance coverage seems to be the most correlated factor that influences the use of trastuzumab in Chinese patients with HER2+ breast cancer.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29794725
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 21
DP  - 2018 May
TI  - Use of trastuzumab as an adjuvant/neoadjuvant therapy in patients with
      HER2-positive breast cancer in China: The Nvwa study.
PG  - e10350
LID - 10.1097/MD.0000000000010350 [doi]
AB  - The aim of this study was to understand current trends in trastuzumab use in
      China as a neoadjuvant/adjuvant therapy for human epidermal growth factor
      receptor-2 positive (HER2+) breast cancer and identify factors influencing
      trastuzumab use.This was a retrospective, multicenter, cross-sectional study of
      patients diagnosed with HER2+ breast cancer (stage I-III), between July 2013 and 
      June 2014, at 155 hospitals in 29 provinces/cities in China. Demographic and
      clinical data, including tumor characteristics and details of
      adjuvant/neoadjuvant therapies used, were collected. Data analysis included
      univariate analysis, multivariate logistic regression, and subgroup analyses.Of
      4994 HER2+ patients (mean age 51.1 +/- 9.9 years) included, only 29.8% received
      trastuzumab, with 30.5% in adjuvant therapy and 18.3% in neoadjuvant therapy. The
      highest rates of adjuvant trastuzumab were in Beijing (59.3%), Jiangsu (57.1%),
      and Ningxia (50.0%), while those of neoadjuvant trastuzumab were in Guangdong
      (24.8%), Beijing (14.1%), and Zhejiang (10.7%). Multivariate regression results
      revealed that factors associated with trastuzumab use were medical insurance
      cover for trastuzumab, residing locally to the hospital, more lymph node
      involvement, and more advanced tumor stage. Subgroup analysis revealed that
      patients receiving neoadjuvant therapy were likely to be younger, premenopausal
      and non-local, and had lymph node metastases, more advanced tumor, and
      progesterone receptor positive tumor.Trastuzumab use in patients with HER2+
      breast cancer is relatively low in China, especially for neoadjuvant therapy.
      Insurance coverage seems to be the most correlated factor that influences the use
      of trastuzumab in Chinese patients with HER2+ breast cancer.
FAU - Li, Junjie
AU  - Li J
AD  - Fudan University Shanghai Cancer Center, Shanghai.
FAU - Shao, Zhimin
AU  - Shao Z
AD  - Fudan University Shanghai Cancer Center, Shanghai.
FAU - Xu, Binghe
AU  - Xu B
AD  - China Medical University, Shenyang.
FAU - Jiang, Zefei
AU  - Jiang Z
AD  - The 307th Hospital of Chinese People's Liberation Army, Beijing.
FAU - Cui, Shude
AU  - Cui S
AD  - Henan Province Cancer Hospital, Zhengzhou.
FAU - Zhang, Jin
AU  - Zhang J
AD  - Tianjin Medical University Cancer Institute and Hospital, Tianjin.
FAU - Liao, Ning
AU  - Liao N
AD  - Guangdong General Hospital, Guangzhou.
FAU - Jiang, Jun
AU  - Jiang J
AD  - Southwest Hospital (the First Affiliated Hospital of the Third Military Medical
      University), Chongqing.
FAU - Wang, Yongsheng
AU  - Wang Y
AD  - Shandong Province Cancer Prevention and Control Institute, Jinan.
FAU - Ouyang, Quchang
AU  - Ouyang Q
AD  - Hunan Cancer Hospital, Changsha.
FAU - Ying, Ziwei
AU  - Ying Z
AD  - Department of Breast Surgery, Liaoning Cancer Hospital & Institute, Shenyang,
      China.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - P188ANX8CK (Trastuzumab)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antineoplastic Agents, Immunological/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/metabolism
MH  - Chemotherapy, Adjuvant/statistics & numerical data
MH  - China
MH  - Cross-Sectional Studies
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Middle Aged
MH  - Neoadjuvant Therapy/statistics & numerical data
MH  - Receptor, ErbB-2/metabolism
MH  - Retrospective Studies
MH  - Trastuzumab/*therapeutic use
EDAT- 2018/05/26 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1097/MD.0000000000010350 [doi]
AID - 00005792-201805250-00001 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(21):e10350. doi: 10.1097/MD.0000000000010350.