Screening of Clinical Practice in Management of Progression on Trastuzumab in metastatic breast cancer

Abstract

Background: Guidelines regarding treatment post progression on Trastuzumab have recently varied with lots of options available. Decision whether to continue on Trastuzumab or to switch to other anti-Her2 treatment varies due to many factors, including the guidelines recommendations, definition of resistance to Trastuzumab, availability of drugs, and socioeconomic factors. The objective of our survey is to evaluate and asses these factors. Material and methods: The survey was emailed to more than 600 oncologists worldwide through BGICS database. Three main questions were covered by the survey; Definition of progression on Trastuzumab, how to deal with progression, and the factors affecting decision making. Results: The survey was send to 612 oncologists worldwide, 167 replied. Participants were mainly from Egypt, Romania, and France. 28.7% consider resistance to Trastuzumab if progression happened while on Trastuzumab, 28.7 % consider resistance if any progression happened after receiving Trastuzumab whatever the duration or the site of progression, 18% consider resistance if progression took place after less than 6 months of receiving Trastuzumab. In case of CNS progression 35.3% had chosen start on Lapatinib, while 25.1% had chosen to change the chemotherapy and continue on Trastuzumab. 18.6% had chosen to give combination of Lapatinib with Trastuzumab. Conclusion: This is the second publication of Medicalsurveys-17 Research Group. Our data revealed that more effort is required to define resistance to Trastuzumab and how to manage patients based on type of resistance and site of progression. Mini Abstract Through this survey, we tried to define the oncologist perspective about resistance to Trastuzumab, the approach to deal with this progression and the factors that affect decision making.