BS11 HERCEPTIN AND EARLY BREAST CANCER: THE FIRST YEAR IN THE REAL WORLD.

Background: Trastuzumab (Herceptin) targets the epidermal growth factor receptor HER2, and was PBS listed on October 1 2006 for HER2+ early breast cancer patients. We undertook an audit of the first year of PBS availability of Herceptin at the 2 major teaching hospitals in Western Australia. Aims: • Determine % of patients with HER2 positive early breast cancer • Determine if patients were omitted from testing • Ascertain % of HER2 positive patients referred for Herceptin treatment and if not why • Examine compliance and short term morbidity and survival. Methods: All early breast cancer patients presenting to Royal Perth and Sir Charles Gairdner Hospitals were identified over the audit period from hospital based cancer registries, cross checked with State Cancer Registry, pathology records, pharmacy data and medical notes. Follow up was to November 2008. Results: 468 eligible patients were identified. 85 had HER 2+/3+ pathology and 22% were aged over 70. Five did not undergo ISH testing (2 because of co-morbidities, 2 because of small disease volume). Of the other 80 only 33 (7% of the total) were eligible for Herceptin after ISH testing. 28 of these were prescribed Herceptin. Reasons for exclusion included co-morbidities, age, metastases, small disease volume and patient choice. 68% of ISH results were not available in time for the multidisciplinary meeting. One patient failed to comply with treatment and 5 stopped early due to co-morbidities. Conclusion: A surprisingly small percentage of patients received Herceptin. Timely communication of ISH results is important. [ABSTRACT FROM AUTHOR]