Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
PURPOSEHuman epidermal growth factor receptor 2 (HER2)–positive breast cancer (HER2+BC) is linked to poorer outcomes. Trastuzumab is the standard treatment, but its high cost limits access in resource-limited settings. This study evaluated the treatment patterns and survival outcomes of patients wit...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American Society of Clinical Oncology
2025-08-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO-24-00612 |
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| Summary: | PURPOSEHuman epidermal growth factor receptor 2 (HER2)–positive breast cancer (HER2+BC) is linked to poorer outcomes. Trastuzumab is the standard treatment, but its high cost limits access in resource-limited settings. This study evaluated the treatment patterns and survival outcomes of patients with HER2 BC in Tanzania.MATERIALS AND METHODSA retrospective hospital-based study was conducted between January 2018 and May 2021 at two prominent public tertiary hospitals in Tanzania. The primary outcome was the 5-year overall survival (OS) rate. Independent variables included demographics, clinical characteristics, and treatment patterns. Survival analysis was conducted using the Kaplan-Meier method. The log-rank test was used in univariate analysis, whereas multivariate Cox regression was used in multivariate analysis.RESULTSA total of 169 patients with nonmetastatic HER2+BC were included, with a median age of 50 years. Most patients were estrogen receptor–positive (50.3%) and diagnosed with stage III BC (58.6%). About 70.4% of patients received trastuzumab, whereas neoadjuvant chemotherapy was administered to 24.3%, and 95.9% underwent mastectomy. Trastuzumab was primarily used in the adjuvant setting rather than the neoadjuvant setting and was more accessible to patients with higher socioeconomic status. The 5-year OS was 65%, with a median survival of 72 months. Trastuzumab reduced the mortality risk by 74%. Extended therapy with trastuzumab benefited patients with hormone receptor–negative HER2+BC more than those who were hormone receptor–positive. Advanced-stage disease increased mortality risk, whereas postmenopausal status and nonsmoking were associated with lower mortality. A higher Eastern Cooperative Oncology Group score (>1) was associated with an increased mortality risk.CONCLUSIONTrastuzumab significantly improves OS in resource-limited settings, particularly in patients with hormone receptor–negative HER2+BC. There are disparities in access to trastuzumab in Tanzania. |
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| ISSN: | 2687-8941 |