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Resumo O objetivo deste artigo é avaliar a efetividade em estudo de vida real do trastuzumabe adjuvante em mulheres com câncer de mama inicial HER-2 positivo na sobrevida global e livre de recidiva. Foi realizado um estudo de coorte retrospectiva em mulheres com câncer de mama inicial HER-2 positivo atendidas no SUS, desde a incorporação da medicação. Trata-se de uma coorte retrospectiva com mulheres com câncer de mama HER-2 positivo, que foram tratadas entre julho de 2012 e maio de 2017 com seguimento até julho de 2021. A taxa de incidência de óbito foi de 2,62 por 100 pessoa/ano e a de recidiva foi de 7,52 por 100 pessoa/ano. A probabilidade de sobrevida em 8,7 anos foi 85,9%, enquanto a probabilidade de sobrevida livre de doença no mesmo período foi 62,8%. O uso de trastuzumabe se mostrou efetivo no tratamento adjuvante do câncer de mama em um serviço público de saúde no Sul do Brasil. Fatores prognósticos associados com pior sobrevida ou recidiva não influenciaram na história natural da doença, exceto doença localmente avançada no início do tratamento. Os dados apresentados podem vir a ser úteis em auxiliar na tomada de decisão sobre a manutenção ou não do uso do trastuzumabe no tratamento do câncer de mama inicial ou localmente avançado no serviço público de saúde brasileiro.
Abstract The aim of this study was to evaluate the effectiveness in a real-world study of adjuvant trastuzumab in women with HER-2+ initial breast cancer in overall survival and recurrence-free survival. A retrospective cohort study was conducted with women who had HER-2+ breast cancer treated with trastuzumab from July 2012 to May 2017 and followed up until July 2021. The death rate was 2.62 per 100 persons/year, and the incidence rate of recurrence was 7.52 per 100 persons/year. The probability of survival at 8.7 years was 85.9%, while the probability of recurrence-free survival in the same period was 62.8%. The use of trastuzumab proved to be effective in the adjuvant treatment of breast cancer in a public health service in southern Brazil. Prognostic factors associated with worse overall survival or relapse did not influence the natural history of the disease, except locally advanced disease at the beginning of treatment. The data presented may prove to be useful in helping to make decisions about whether to use trastuzumab in the treatment of initial or locally advanced breast cancer in the Brazilian SUS.
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Introduction: The heterogeneous nature and intrinsically aggressive tumor pathology of the triple negative breast cancer subtype results in an unfavorable prognosis and limited clinical success. The use of hematological components of the systemic inflammatory response for patients with triple-negative breast cancer can add important prognostic information to the criteria traditionally used for cancer patients, since inflammation can promote tumor progression support by affecting the stages of tumorigenesis. Objectives: The aim of this study was to evaluate the hematological parameters neutrophil/lymphocyte, monocyte/lymphocyte and platelet/lymphocyte ratios as prognostic indicators in patients with triple-negative breast cancer. Methods: This was a singlecenter retrospective observational study in an oncology referral hospital in the South region of Brazil. Electronic medical records of patients diagnosed with triple-negative breast cancer from 2012 to 2016 were reviewed and analyzed using SPSS. Results: The low blood cell ratio groups had significantly higher overall survival than the high blood cell ratio groups. Univariate analysis also confirmed the correlation of patients in the high blood cell ratio groups with unfavorable results. Conclusions: Hematological components of the systemic inflammatory response are promising prognostic indicators. More studies on the subject should be carried out to assist in future medical decision-making so these parameters of easy assessment and low cost can be introduced in clinical practice.