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Concurrence of Disease Free Survival expectancy estimate of Trastuzumab in HER2- Positive Breast Cancer: Results from single centerretrospective data-Scientific conferences in Bangalore.

Trastuzumab is one of the personalized drugs approved over a decade ago to treat breast cancer patients based on HER-2 neu gene status (H+BCP). This approach of personalizing treatment is reported with better outcomes in terms of efficacy and survival. However, there is a paucity of data on Trastuzumab efficacy and safety in India population.

OBJECTIVES:
Drug utilization evaluation of Trastuzumab in H+BCPto estimate prescribing patterns, efficacy and safety in a tertiary care teaching hospital.

METHOD:
H+BCP from Jan 2012 to October 2014 were taken retrospectively and analyzed to compare the 3-year disease free survival (DFS) between chemotherapy with Trastuzumab (Chemo+T) and chemotherapy (Chemo) alone. The cohort included was with non-metastatic diseaseand followed up till the event (metastasis and recurrence).

RESULTS:
A total of 1,653 BCPfrom 2012 to 2017 were screened for ER, PR and HER-2 status of which 217 (13.12%)were diagnosed H+BCP by IHC and FISH test. Of the 217 patients, 61 (28.11%) received Chemo+Tand 43(19.81%) received Chemo alone. The treatment plan implemented for majority in Chemo+T and Chemo alone was BRAJACTT and BRAJACT respectively .3-year DFS was longer in patients receiving Chemo+Tthan those who received Chemo alone(71.2% and 44.2% respectively (p=0.046).) The mean 3-year DFS time Chemo+Tand Chemo was found to be 947.29 and 827.10 days respectively. One patient developed Trastuzumab induced cardiotoxicity.The main adverse effects in Chemo only receiving cohort were neutropenia (4.3%) and nausea (1.6%).

CONCLUSION:
There was only one study reported previously about 5 year DFS with MAb superior to chemo group.Our studyfinding also goes with that finding, however were able to follow only 3yras there were a lot of patients lost to follow up after that.This could be a challenging situation for patients, care givers, HCP considering the epidemiology of patients andresources at our location.

FUTURE DIRECTIONS:
We hence sincerely believe that there needs to be a multi prompt approach of policy development and implementation toenhance personalized therapy “targeting” the patients affected.

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World Congress on Genetics,
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