Efectividad y seguridad entre trastuzumab subcutáneo e intravenoso en cáncer de mama HER2 positivo
Fecha
2022
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: En 2020, en todo el mundo se diagnosticó cáncer de mama a 2,3 millones de mujeres, y 685 000 fallecieron por esa enfermedad. El gen que codifica HER2 (ERBB2, antes conocido como neu) está amplificado y sobreexpresado en aproximadamente el 20% de los cánceres de mama recién diagnosticados, y se asocia con un peor pronóstico para esta población. Al mismo tiempo, la generación de un conjunto de anticuerpos monoclonales como el trastuzumab ha generado cambios en la sobrevidad libre de enfermedad a 3 años. Objetivo: Es determinar la efectividad y seguridad entre el Trastuzumab subcutáneo e intravenoso en pacientes con cáncer de mama HER2, del Hospital de Especialidades “Dr. Abel Gilbert Pontón”. Metodología: Estudio observacional no experimental, retrospectivo, transversal, correlacional, analítico, realizado en el Hospital de Especialidades “Dr. Abel Gilbert Pontón” de la ciudad de Guayaquil, Ecuador. El universo fueron todas las pacientes de consulta externa, tratadas en el departamento de quimioterapia del Servicio de Oncología, del Hospital de Especialidades “Dr. Abel Gilbert Pontón”, con diagnóstico de cáncer de mama HER2 positivo, en el periodo comprendido desde noviembre 2017 hasta noviembre 2020; para la muestra se recolectaron los datos de las historias clínicas y se plasmaron en una hoja previamente diseñada, los mismos que fueron seleccionados acorde a los criterios de inclusión y exclusión resultando 106 pacientes para el presente estudio. Resultado: La mayor cantidad de pacientes en este estudio tiene respuesta terapéutica completa (33 pacientes que corresponden el 31.13%) según la resonancia magnética (RNM) y tomografía axial computarizada (TAC). La sobre vida libre de enfermedad a 3 años es mayor en la vía de administración subcutánea (26 pacientes que corresponde al 24.53%). Las reacciones adversas más comunes que se identificaron son nausea y vómito (45 pacientes que correspondes el 42,45%) y alopecia (20 pacientes que corresponde el 18,87%). Las ventajas de la administración del trastuzumab: el tiempo de administración fue menor en la vía subcutánea (5-10 minutos) y se utilizaron menos cantidad de insumos en la vía subcutánea (1-3 insumos). Conclusión: Se concluye que en el presente estudio, la respuesta terapéutica predominante es la respuesta completa, las reacciones adversas más comunes, que se presentaron con mayor frecuencia son: náuseas y vómitos, con predominio en la vía subcutánea; seguido de alopecia con igualdad en ambas vías de administración; dentro de las ventajas de la administración del trastuzumab, el tiempo de administración es menor en la vía de administración subcutánea, así como el número de insumos utilizados.
Palabras clave. Cáncer, mama, HER2 positivo, Efectividad, Seguridad.
Background: In 2020, 2.3 million women were diagnosed with breast cancer worldwide, and 685,000 died of the disease. The gene encoding HER2 (ERBB2, formerly known as neu) is amplified and overexpressed in approximately 20% of newly diagnosed breast cancers, and is associated with a worse prognosis for this population. At the same time, the generation of a set of monoclonal antibodies such as trastuzumab has generated changes in disease-free survival at 3 years. Objective: It is to determine the effectiveness and safety between subcutaneous and intravenous Trastuzumab in patients with HER2 breast cancer, at the Hospital de Especialidades “Dr. Abel Gilbert Pontón ”. Methodology: Non-experimental, retrospective, cross-sectional, correlational, analytical observational study, carried out at the Hospital de Especialidades “Dr. Abel Gilbert Pontón ”from the city of Guayaquil, Ecuador. The universe consisted of all the outpatient patients, treated in the chemotherapy department of the Oncology Service, Hospital de Especialidades “Dr. Abel Gilbert Pontón ”, with a diagnosis of HER2 positive breast cancer, in the period from November 2017 to November 2020; For the sample, the data from the medical records were collected and recorded in a previously designed sheet, which were selected according to the inclusion and exclusion criteria, resulting in 106 patients for the present study. Result: The largest number of patients in this study had a complete therapeutic response (33 patients corresponding to 31.13%) according to magnetic resonance imaging (MRI) and computed tomography (CT). The 3-year disease-free survival is greater in the subcutaneous route of administration (26 patients, which corresponds to 24.53%). The most common adverse reactions that were identified are nausea and vomiting (45 patients corresponding to 42.45%) and alopecia (20 patients corresponding to 18.87%). The advantages of the administration of trastuzumab: the administration time was shorter in the subcutaneous route (5-10 minutes) and fewer inputs were used in the subcutaneous route (1-3 inputs). Conclusion: It is concluded that in the present study, the predominant therapeutic response is the complete response. The most common adverse reactions, which occurred more frequently, are: nausea and vomiting, with a predominance in the subcutaneous route; followed by alopecia with equality in both routes of administration; Among the advantages of the administration of trastuzumab, the administration time is shorter in the subcutaneous route of administration, as well as the number of inputs used. Key words: Cancer, breast, HER2 positive, Effectiveness, Safety.
Background: In 2020, 2.3 million women were diagnosed with breast cancer worldwide, and 685,000 died of the disease. The gene encoding HER2 (ERBB2, formerly known as neu) is amplified and overexpressed in approximately 20% of newly diagnosed breast cancers, and is associated with a worse prognosis for this population. At the same time, the generation of a set of monoclonal antibodies such as trastuzumab has generated changes in disease-free survival at 3 years. Objective: It is to determine the effectiveness and safety between subcutaneous and intravenous Trastuzumab in patients with HER2 breast cancer, at the Hospital de Especialidades “Dr. Abel Gilbert Pontón ”. Methodology: Non-experimental, retrospective, cross-sectional, correlational, analytical observational study, carried out at the Hospital de Especialidades “Dr. Abel Gilbert Pontón ”from the city of Guayaquil, Ecuador. The universe consisted of all the outpatient patients, treated in the chemotherapy department of the Oncology Service, Hospital de Especialidades “Dr. Abel Gilbert Pontón ”, with a diagnosis of HER2 positive breast cancer, in the period from November 2017 to November 2020; For the sample, the data from the medical records were collected and recorded in a previously designed sheet, which were selected according to the inclusion and exclusion criteria, resulting in 106 patients for the present study. Result: The largest number of patients in this study had a complete therapeutic response (33 patients corresponding to 31.13%) according to magnetic resonance imaging (MRI) and computed tomography (CT). The 3-year disease-free survival is greater in the subcutaneous route of administration (26 patients, which corresponds to 24.53%). The most common adverse reactions that were identified are nausea and vomiting (45 patients corresponding to 42.45%) and alopecia (20 patients corresponding to 18.87%). The advantages of the administration of trastuzumab: the administration time was shorter in the subcutaneous route (5-10 minutes) and fewer inputs were used in the subcutaneous route (1-3 inputs). Conclusion: It is concluded that in the present study, the predominant therapeutic response is the complete response. The most common adverse reactions, which occurred more frequently, are: nausea and vomiting, with a predominance in the subcutaneous route; followed by alopecia with equality in both routes of administration; Among the advantages of the administration of trastuzumab, the administration time is shorter in the subcutaneous route of administration, as well as the number of inputs used. Key words: Cancer, breast, HER2 positive, Effectiveness, Safety.
Descripción
PDF
Palabras clave
Efectividad, Neoplasias de la mama, Trastuzumab, HER2 positivo, Epidemiología analítica, Estudios retrospectivos, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador