Real‐world comparative effectiveness and safety of Pertuzumab in patients with HER2+ metastatic breast cancer: A pan‐Canadian population‐based cohort study

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.

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Publication Details

Journal
International Journal of Cancer
Published
2025-04-23
DOI
https://doi.org/10.1002/ijc.35448
Citations
2
Primary Topic
HER2/EGFR in Cancer Research
Type
article
Field-Weighted Citation Impact
2.09

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article

Real‐world comparative effectiveness and safety of Pertuzumab in patients with HER2+ metastatic breast cancer: A pan‐Canadian population‐based cohort study

Kelvin Chan, Chris Folkins, Caroline E. Muñoz, Chandy Somayaji et al.
2 citations
International Journal of Cancer
HER2/EGFR in Cancer Research
2.09
article

Real‐world comparative effectiveness and safety of Pertuzumab in patients with HER2+ metastatic breast cancer: A pan‐Canadian population‐based cohort study

Kelvin Chan, Chris Folkins, Caroline E. Muñoz, Chandy Somayaji, Carrie O’Conaill, Ning Liu, Chenthila Nagamuthu, Cynthia Kendell, Erin Strumpf, Rebecca E. Mercer, Mina Tadrous, Winson Y. Cheung, Robin Urquhart, Pam Takhar, Jeff Dowden, Donna Turner, Zeb Aurangzeb, Lynn Lethbridge, Stuart Peacock, Philip Q. Ding, Jaclyn Beca, Claire de Oliveira, Reka Pataky, Avram Denburg, Wei Fang Dai, Hui Xiong, Ted McDonald, David Tran, K.A. Vriends, Carol McClure, Riaz Alvi
article en
2 citations

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.

International Journal of CancerVol. 157(5)
University of New Brunswick (CA), Dalhousie University (CA), Sunnybrook Health Science Centre (CA), Centre for Addiction and Mental Health (CA), University of Calgary (CA), Simon Fraser University (CA), University of Toronto (CA), Hospital for Sick Children (CA), Women's College Hospital (CA), Health Sciences Centre (CA), University of Saskatchewan (CA), CancerCare Manitoba (CA), Saskatchewan Cancer Agency (CA), Public Health Ontario (CA), Newfoundland and Labrador Centre for Applied Health Research (CA), Canadian Centre for Applied Research in Cancer Control (CA), OmniActive Health Technologies (Canada) (CA), Government of Manitoba (CA), University of Manitoba (CA), McGill University (CA), University of York (GB)
Canadian Institutes of Health Research
Good health and well-being
Openalex Percentile: Top 13%
HER2/EGFR in Cancer Research
2.09
DOIOpen Access PDFOpenAlex
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