Fecha de recepción: 03/05/2017 – Fecha de aceptación: 20/06/2017
Faus Soler MT1, Koninckx Cañada M1, López-Montenegro Soria MA2, Marco Garbayo JL1, Pérez Castelló I1,
Bourgon Baquedano L1, Peiró Barber E1
1 Servicio de Farmacia. Hospital Francesc de Borja. Gandia. Valencia (España)
2 Servicio de Farmacia. Hospital Lluís Alcanyís. Xàtiva. Valencia (España)
M. Teresa Faus Soler
Hospital Francesc de Borja
(Servicio de Farmacia)
Avenida de la Medicina, 6
46702 Gandía (Valencia)
Correo electrónico: email@example.com
Objective: To evaluate the effectiveness, safety and cost of oncologic treatment and its compliance with the guidelines established according to the molecular subtype in patients diagnosed with metastatic breast cancer (MBC).
Method: Ambispective observational study in patients background with MBC treated at our hospital during 2015-2016. Patient identification and data extraction were performed from the electronic prescription program and computerized medical history. Variables analyzed: clinical-descriptive (age, sex, treatment lines, antineoplastic schemes); effectiveness according to RECIST criteria [partial response (PR), stable disease (SD), progression of disease (PD), time to progression (TP) and overall survival (OS)] and safety (adverse effects according to Common Terminology Criteria for Adverse Events v4.0).
Results: 19 patients were included, mean aged 56±13 years, all woman and luminal molecular subtype 42.1%, Her2+ 36.8% and triple-negative (TN) 21.1%. Letrozole was mostly used as hormone therapy. Single agent was predominant, being the most used: paclitaxel and doxorubicin in luminal subtype, docetaxel in Her2+ and paclitaxel and capecitabine in TN. Four patients received combined chemotherapy in the second line. Biological therapy associated with chemotherapy was based on trastuzumab, pertuzumab and trastuzumab-emtansin on Her2+ and bevacizumab on TN and luminal. 47.4% of patients had PR/SD, 26.3% exitus, 21% PD. The median OS was 15 months. 99 drug adverse effects were detected, including anemia (16.2%), neurotoxicity (13.1%) and neutropenia (10.1%). 15.1% of these adverse effects were grade 3-4. The monthly cost ranged between 30-7,787€.
Conclusions: Treatments used were suitable to the recommendations. There was a drug-specific toxicity. Response and cost variability were observed according to molecular subtype.
Key Words: Metastatic breast cancer, chemotherapy, biological therapy, clinical effectiveness, safety, drug-related side effects, adverse effects, cost.