Preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection in patients with HER2-positive early breast cancer (PHranceSCa): A randomised, open-label phase II study

Eur J Cancer. 2021 Jul:152:223-232. doi: 10.1016/j.ejca.2021.03.047. Epub 2021 Jun 16.

Abstract

Aim: The aim of the study was to assess patient preference for the fixed-dose combination of pertuzumab and trastuzumab for subcutaneous injection (PH FDC SC) in patients with HER2-positive early breast cancer in PHranceSCa (NCT03674112).

Materials and methods: Patients who completed neoadjuvant P + H + chemotherapy + surgery were randomised 1:1 to three intravenous (IV) P + H cycles followed by three cycles of PH FDC SC or vice versa (crossover) and then chose subcutaneous (SC) injection or IV infusion to continue up to 18 cycles (continuation). Assessments were via patient and healthcare professional (HCP) questionnaires.

Results: One hundred and sixty patients were randomised (cut-off: 24 February 2020); 136 (85.0%, 95% confidence interval: 78.5-90.2%) preferred SC; 22 (13.8%) preferred IV; 2 (1.3%) had no preference. The main reasons for SC preference were reduced clinic time (n = 119) and comfort during administration (n = 73). One hundred and forty-one patients (88.1%) were very satisfied/satisfied with SC injection versus 108 (67.5%) with IV infusion; 86.9% chose PH FDC SC continuation. HCP perceptions of median patient treatment room time ranged from 33.0-50.0 min with SC and 130.0-300.0 min with IV. Most adverse events (AEs) were grade 1/2 (no 4/5s); serious AE rates were low. AE rates before and after switching were similar (cycles 1-3 IV → cycles 4-6 SC: 77.5% → 72.5%; cycles 1-3 SC → cycles 4-6 IV: 77.5% → 63.8%).

Conclusion: Most patients strongly preferred PH FDC SC over P + H IV. PH FDC SC was generally well tolerated, with no new safety signals (even when switching), and offers a quicker alternative to IV infusion.

Keywords: Adjuvant; Early breast cancer; Fixed dose; Healthcare resource; Patient preference; Patient-reported outcomes; Pertuzumab; Quality of life; Subcutaneous; Trastuzumab.

Publication types

  • Clinical Trial, Phase II
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Breast Neoplasms / diagnosis
  • Breast Neoplasms / immunology
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy*
  • Chemotherapy, Adjuvant / methods
  • Chemotherapy, Adjuvant / psychology
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Cross-Over Studies
  • Drug Combinations
  • Female
  • Humans
  • Infusions, Intravenous / adverse effects
  • Infusions, Intravenous / psychology
  • Injections, Subcutaneous / adverse effects
  • Injections, Subcutaneous / psychology
  • Middle Aged
  • Neoadjuvant Therapy / methods*
  • Neoadjuvant Therapy / psychology
  • Neoadjuvant Therapy / statistics & numerical data
  • Neoplasm Staging
  • Patient Preference / statistics & numerical data*
  • Patient Satisfaction
  • Receptor, ErbB-2 / analysis
  • Receptor, ErbB-2 / metabolism
  • Trastuzumab / administration & dosage*
  • Young Adult

Substances

  • Antibodies, Monoclonal, Humanized
  • Drug Combinations
  • ERBB2 protein, human
  • Receptor, ErbB-2
  • pertuzumab
  • Trastuzumab

Associated data

  • ClinicalTrials.gov/NCT03674112