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  • Safety and tolerability of subcutaneous trastuzumab and intravenous pertuzumab as adjuvant treatment for HER2 positive breast cancer: a pilot study

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Original research
Safety and tolerability of subcutaneous trastuzumab and intravenous pertuzumab as adjuvant treatment for HER2 positive breast cancer: a pilot study
  1. Chi Yan Wong1,
  2. Roland Leung2,
  3. Gin Wai Kwok1,
  4. Josephine Tsang1,
  5. Bryan Li1,
  6. Thomas Yau2,
  7. Joanne Chiu2
  1. 1 Medicine, Queen Mary Hospital, Hong Kong, Hong Kong
  2. 2 Medicine, University of Hong Kong, Hong Kong, Hong Kong
  1. Correspondence to Dr Joanne Chiu, Department of Medicine, University of Hong Kong, Hong Kong, Hong Kong; jwychiu{at}hku.hk

Abstract

Background Subcutaneous (SC) trastuzumab is similar to intravenous trastuzumab in terms of pharmacokinetics, efficacy and tolerability. The use of dual anti-HER2 agents trastuzumab and pertuzumab has become the new standard for node-positive HER2-positive breast cancers at adjuvant setting, but the safety and tolerability of combining SC trastuzumab and intravenous pertuzumab is not well studied.

Methods This was a prospective single-arm pilot study with locally advanced HER2-positive breast cancer who received adjuvant SC trastuzumab and intravenous pertuzumab after standard anti-HER2 treatment with chemotherapy. Primary outcomes included adverse events (AEs), severe AEs and cardiac AEs. Secondary outcome was invasive disease-free survival (iDFS).

Results With a median follow-up of 21.7 months, 20 patients were enrolled. One patient (5%) developed asymptomatic drop in left ventricular ejection fraction from 69% to 53%. Two patients (10%) developed grade 1 injection site reaction related to SC trastuzumab. There were no grade 2 or above AEs. All AEs were transient. No new AEs were observed. The 1-year iDFS was 90% (95% CI 0.656 to 0.974)

Conclusions Combination of SC trastuzumab and intravenous pertuzumab for HER2-positive breast cancer is a safe and well-tolerated option in adjuvant setting.

  • breast tumours

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information. The authors confirm that the data supporting the findings of this study are available within the article.

http://dx.doi.org/10.1136/postgradmedj-2021-140319

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information. The authors confirm that the data supporting the findings of this study are available within the article.

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    Footnotes

    • Contributors JC was the principal investigator. JC and RL planned and designed the study. GWK, CYW, BL, JT, RL and JC contributed to the implementation and reporting of the study. CYW drafted the manuscript. JC, RL and TY revised the manuscript and contributed to important comments. All authors discussed the result and commented on the manuscript.

    • Funding This study did not receive funding from any grant.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.