Adherence to human epidermal growth factor receptor-2 testing and adjuvant trastuzumab treatment guidelines in Ontario

Author:

Marshall Deborah A1234,Ferrusi Ilia L124,Trudeau Maureen456,Leighl Natasha B467,Hoch Jeffrey S489,Grazziotin Luiza R3ORCID,Khong Hoa10,Pullenayegum Eleanor1112,Earle Craig C413

Affiliation:

1. Centre for Evaluation of Medicines, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada

2. Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada

3. Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada

4. Canadian Centre for Applied Research in Cancer Control (ARCC), Vancouver, British Columbia, Canada

5. Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada

6. Department of Medicine, University of Toronto, Toronto, Ontario, Canada

7. Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada

8. Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, Ontario, Canada

9. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

10. Alberta Bone & Joint Health Institute, Calgary, Alberta, Canada

11. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, Ontario, Canada

12. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

13. Ontario Institute for Cancer Research, Toronto, Ontario, Canada

Abstract

Objectives We evaluated adherence of human epidermal growth factor receptor-2 testing using immunohistochemistry and fluorescence in situ hybridization, as well as adjuvant trastuzumab treatment according to Canadian guidelines, and predictors of trastuzumab use in early-stage breast cancer in Ontario. Methods Retrospective cohort of early-stage breast cancer patients identified in the Ontario Cancer Registry. Human epidermal growth factor receptor-2 test type, sequence, result(s), tumor grade, and hormone receptor status were abstracted from Ontario Cancer Registry pathology reports. Trastuzumab treatment was determined from provincial cancer agency records. Other variables were determined from administrative data sources. Logistic regression models were used to estimate adjusted odds ratios for factors associated with guideline adherence. Results The first human epidermal growth factor receptor-2 test result was the strongest predictor of confirmatory testing ( p < 0.05). Human epidermal growth factor receptor-2 testing by immunohistochemistry accounted for the majority of documented first tests (94%; n = 8249). Overall, 27% ( n = 2360) of tested patients received a second test by fluorescence in situ hybridization (46%) or immunohistochemistry (49%) assay. Most human epidermal growth factor receptor-2 equivocal patients (89%; n = 784) received a confirmatory test. Among human epidermal growth factor receptor-2-positive patients, only 57% ( n = 385) received trastuzumab treatment within the study period. Human epidermal growth factor receptor-2 status was the strongest predictor of trastuzumab use. Younger patients (<70 years at diagnosis) and negative hormone receptor status had higher odds of trastuzumab treatment ( p < 0.05) compared to older and positive hormone receptor status patients. Conclusions Immunohistochemistry use as a first test was largely consistent with Canadian guidelines; however, immunohistochemistry was frequently used as a confirmatory test, which is not guideline-concordant. Monitoring these testing and treating patterns is necessary to optimize health outcomes associated with trastuzumab.

Funder

Ontario Institute for Cancer Research

Ministry of Health and Long-Term Care

Publisher

SAGE Publications

Subject

Pharmacology (medical),Oncology

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3