Real‐world comparative effectiveness and safety of Pertuzumab in patients with HER2+ metastatic breast cancer: A pan‐Canadian population‐based cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: We assessed the comparative effectiveness and safety of pertuzumab plus trastuzumab and chemotherapy versus trastuzumab and chemotherapy for patients with HER2+ metastatic breast cancer (mBC) in Canada. We conducted a population-based retrospective study of patients receiving first-line treatment for mBC across eight Canadian provinces. Patients receiving trastuzumab and chemotherapy were historical comparators, and patients receiving pertuzumab plus trastuzumab and chemotherapy were the treatment group. Patients were followed until death or up to 5 years following the start of treatment (maximum follow-up to December 31, 2019). The primary outcome was overall survival (OS). One-year cumulative incidence and RDs were calculated for safety outcomes including hospitalization, emergency department visits, febrile neutropenia, and cardiac-related events. Propensity score matching (PSM) and inverse-probability of treatment weighting (IPTW) were applied within provinces. Individual provincial survival estimates were pooled using random effects meta-analysis. 3063 patients who received first-line treatment for mBC were identified. Median OS was higher among treatment patients compared to comparator patients in most provinces. Pertuzumab was associated with a statistically significantly lower risk of mortality (pooled HRs, PSM: 0.65, 95%CI: 0.57-0.74; IPTW: 0.65, 95% CI: 0.61-0.70). The treatment group had a lower risk of hospitalization compared to the comparator group (pooled RD: -0.05, 95% CI: [-0.09]-[-0.01]). No difference in 1-year cumulative incidence of cardiac-related events was identified between groups. Pertuzumab use in practice was associated with statistically significant improved survival without apparent safety concerns among patients with mBC. Real-world evaluations allow for assessments of publicly funded treatments to inform funding policies.
Source: International Journal of Cancer
DOI: 10.1002/ijc.35448
Authors: Caroline E. Muñoz, Wei Fang Dai, Winson Y. Cheung, Claire de Oliveira, Reka E. Pataky, Philip Q. Ding, David A. Tran, Zeb Aurangzeb, Chenthila Nagamuthu, Ning Liu, Lynn Lethbridge, Carol McClure, Kim Vriends, Hui Xiong, Chris Folkins, Chandy Somayaji, Stuart Peacock, Riaz Alvi, Donna Turner, Carrie O'Conaill, Ted McDonald, Robin Urquhart, Cynthia Kendell, Jeff Dowden, Erin Strumpf, Avram Denburg, Jaclyn M. Beca, Rebecca E. Mercer, Mina Tadrous, Pam Takhar, Kelvin K. W. Chan
Institutions: Canadian Centre for Applied Research in Cancer Control, Ontario Health, University of Toronto, University of Calgary, Centre for Addiction and Mental Health, Institute for Clinical Evaluative Sciences, University of York, BC Cancer Agency, Saskatchewan Cancer Agency, Government of Manitoba, University of Manitoba, Dalhousie University, Newfoundland and Labrador Health Services, University of New Brunswick, New Brunswick Institute for Research, Data and Training, Simon Fraser University, University of Saskatchewan, CancerCare Manitoba, McGill University, Hospital for Sick Children, Sunnybrook Health Science Centre, Women's College Hospital
Language: English
Topic: HER2/EGFR in Cancer Research
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,030
OpenAlex ID: W4409713352