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Implementation of trastuzumab in conjunction with adjuvant chemotherapy in the treatment of non-metastatic breast cancer in the Netherlands

  • Epidemiology
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Abstract

Trastuzumab in conjunction with adjuvant chemotherapy markedly improves outcome. In the Netherlands, a national guideline was released in September 2005 stating that trastuzumab should be given in conjunction with adjuvant chemotherapy in women with HER2-positive breast cancer. Aim of this study was to identify the number of women with HER2-positive breast cancer and to evaluate the level of implementation of adjuvant trastuzumab in clinical practice nationwide. Women diagnosed with primary breast cancer between September 2005 and January 2007 were selected from the Netherlands Cancer Registry (NCR). HER2 status, adjuvant treatment and reasons to withhold trastuzumab were registered. 14,934 Breast cancer patients were diagnosed in this period of whom 1,928 (13%) had a HER2-positive tumour. Of all HER2-positive women receiving adjuvant chemotherapy, 66 (6%) did not receive trastuzumab. This percentage decreased from 10% at the time of introduction of the guideline to 4% in the study period September 2005–December 2006. Most common reasons to withhold trastuzumab were cardiovascular disease (29%) and patient refusal (21%). Of all HER2-positive patients who received adjuvant chemotherapy, 94% received trastuzumab. The implementation of trastuzumab in clinical practice was realized within 8 months after introduction of the new guideline.

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Authors and Affiliations

  1. Department of Research, Comprehensive Cancer Centre North East, P.O. Box 330, 9700 AH, Groningen, The Netherlands

    L. de Munck & S. Siesling

  2. Department of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    M. Schaapveld

  3. Department of Health Technology & Services Research, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands

    S. Siesling

  4. Department of Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    J. Wesseling

  5. Department of Epidemiology, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    A. C. Voogd

  6. Department of Research, Comprehensive Cancer Centre South (CCCS), P.O. Box 231, 5600 AE, Eindhoven, The Netherlands

    A. C. Voogd

  7. Division of Medical Oncology, Department of Internal Medicine, GROW – School for Oncology and Developmental Biology, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    V. C. G. Tjan-Heijnen

  8. Comprehensive Cancer Centre North East, P.O. Box 330, 9700 AH, Groningen, The Netherlands

    R. Otter

  9. Department of Medical Oncology, University Medical Centre Groningen, P.O. Box 30001, 9700 RB, Groningen, The Netherlands

    P. H. B. Willemse

Authors
  1. L. de Munck
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  2. M. Schaapveld
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  3. S. Siesling
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  4. J. Wesseling
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  5. A. C. Voogd
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  6. V. C. G. Tjan-Heijnen
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  7. R. Otter
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  8. P. H. B. Willemse
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Correspondence to L. de Munck.

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de Munck, L., Schaapveld, M., Siesling, S. et al. Implementation of trastuzumab in conjunction with adjuvant chemotherapy in the treatment of non-metastatic breast cancer in the Netherlands. Breast Cancer Res Treat 129, 229–233 (2011). https://doi.org/10.1007/s10549-011-1451-0

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  • DOI: https://doi.org/10.1007/s10549-011-1451-0

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