CAN WE CURE BREAST CANCER WITH ADJUVANT TRASTUZUMAB?
Evaluating the costs and benefits

Joseph Ragaz, MD, FRCPC

Very few developments have galvanized the breast cancer establishment more profoundly than the April 25, 2005 news alert from the US-based National Institutes of Health (NIH). An unexpectedly large benefit was reported for trastuzumab given as adjuvant treatment to women with HER2+ early breast cancer in 2 trials conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP) and the North Central Cancer Treatment Group (NCCTG).

 

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Top-line summary
The news of the results from 3 recent trials of adjuvant trastuzumab treatment in early breast cancer, showing a large reduction in cancer recurrence in women with HER2-positive (HER2+) disease, is a major success for the concept of targeted therapy using biological agents. Because 20% to 30% of all newly diagnosed women have HER2+ breast cancer, making trastuzumab available to all those who stand to benefit entails huge costs for healthcare providers — an estimated $C160 million per year in Canada. Here, Joseph Ragaz, MD, a member of the Editorial Advisory Board of Oncology Exchange, reports the key findings of the 3 trials, NSABP B-31, NCCTG-N9831 and HERA, as presented at the recent Annual Meeting of the American Society of Clinical Oncology (ASCO), and proposes an approach for how decisionmakers should evaluate the costs and benefits of this treatment.
 
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