Adjuvant Trastuzumab May Be Insufficiently Used in Older Women With Breast Cancer
Reeder-Hayes et al found that adjuvant trastuzumab (Herceptin) may be underused in older women with early-stage HER2-positive breast cancer and reported their study results in the Journal of Clinical Oncology. Adjuvant trastuzumab also was used less often in black women than in white women.
Rates of Use
The study involved Surveillance, Epidemiology, and End Results (SEER)-Medicare data from a national cohort of 1,362 women aged ≥ 65 years with stages I to III HER2-positive disease diagnosed in 2010 and 2011. The cohort included 1,162 white women, 104 black women, and 96 women of other minorities.
Overall, 50% of white women, 40% of black women, and 42% of other minority women received some trastuzumab within 1 year of diagnosis. Rates of receipt for white and black women were 38% and 24% in stage I, 57% and 49% in stage II, and 74% and 56% in stage III disease, respectively. In multivariate analysis adjusting for tumor characteristics, poverty, and comorbidity, black women were significantly less likely than white women to receive trastuzumab (risk ratio = 0.745, 95% confidence interval = 0.60–0.93).
The investigators concluded: “Approximately one half of patients 65 years of age and older with stage I to III breast cancer do not receive trastuzumab-based therapy, which includes many with locally advanced disease. Significant racial disparities exist in the receipt of this highly effective therapy. Further research that identifies barriers to use and increases uptake of trastuzumab could potentially improve recurrence and survival outcomes in this population, particularly among minority women.”
The study was supported by the National Center for Advancing Translational Sciences and the University Cancer Research Fund through the State of North Carolina.
Katherine Reeder-Hayes, MD, MBA, of the University of North Carolina at Chapel Hill, is the corresponding author of the Journal of Clinical Oncology article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
