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: Lemi Ndugumbi Zinga, Queen Godfrey Tarimo, Kelvin Mbelekwa, Mamsau Twalib Ngoma, Emmanuel L. Lugina
Format: Article
Language:English
Published: American Society of Clinical Oncology 2025-08-01
Series:JCO Global Oncology
Online Access:https://ascopubs.org/doi/10.1200/GO-24-00612
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author Lemi Ndugumbi Zinga
Queen Godfrey Tarimo
Kelvin Mbelekwa
Mamsau Twalib Ngoma
Emmanuel L. Lugina
author_facet Lemi Ndugumbi Zinga
Queen Godfrey Tarimo
Kelvin Mbelekwa
Mamsau Twalib Ngoma
Emmanuel L. Lugina
author_sort Lemi Ndugumbi Zinga
collection DOAJ
description 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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spelling doaj-art-f8ded80a3f2a48529b7061c875f3473a2025-08-20T04:01:08ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412025-08-011110.1200/GO-24-00612Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in TanzaniaLemi Ndugumbi Zinga0Queen Godfrey Tarimo1Kelvin Mbelekwa2Mamsau Twalib Ngoma3Emmanuel L. Lugina4Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, TanzaniaMuhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, TanzaniaMuhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, TanzaniaMuhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, TanzaniaMuhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, TanzaniaPURPOSEHuman 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.https://ascopubs.org/doi/10.1200/GO-24-00612
spellingShingle Lemi Ndugumbi Zinga
Queen Godfrey Tarimo
Kelvin Mbelekwa
Mamsau Twalib Ngoma
Emmanuel L. Lugina
Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
JCO Global Oncology
title Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
title_full Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
title_fullStr Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
title_full_unstemmed Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
title_short Treatment Patterns and Outcomes of Patients With Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer in Tanzania
title_sort treatment patterns and outcomes of patients with human epidermal growth factor receptor 2 positive breast cancer in tanzania
url https://ascopubs.org/doi/10.1200/GO-24-00612
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