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Adjuvant trastuzumab in early HER2-positive breast cancer: Journeying towards the optimal duration of therapy in South Africa

R J Wiseman, J Riddin, J Jugathpal, A J Parrish, P Ruff, M Blockman

Abstract


Trastuzumab was added to the South African Essential Medicines List (EML) in 2017 for the adjuvant management of human epidermal growth factor receptor 2 (HER2)-positive early breast cancer. However, access has remained inconsistent, as some provinces continue to regard trastuzumab as unaffordable within the contexts of their respective oncology budgets. The intention of providing access to trastuzumab through its inclusion on the EML, therefore, has not been met. The National EML Committee (NEMLC) recently reviewed newly published peer-reviewed information investigating the impact of a shorter trastuzumab treatment period on both clinical efficacy and safety. On account of this review, and with a view to improving access while reducing cost and toxicity, the NEMLC has revised the duration of trastuzumab therapy, i.e. from 12 months to 6 months in the adjuvant management of early HER2-positive breast cancer. This article explores and reports on the data used to make this policy amendment.


Authors' affiliations

R J Wiseman, Liberty Health (Pty) Ltd, Cape Town; and Essential Medicines List Committee, National Department of Health, Pretoria, South Africa

J Riddin, Affordable Medicines Directorate, National Department of Health, Pretoria, South Africa

J Jugathpal, Affordable Medicines Directorate, National Department of Health, Pretoria, South Africa

A J Parrish, Essential Medicines List Committee, National Department of Health, Pretoria; and Department of Internal Medicine, Frere and Cecilia Makiwane hospitals, East London, South Africa

P Ruff, Essential Medicines List Committee, National Department of Health, Pretoria; and Division of Medical Oncology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

M Blockman, Essential Medicines List Committee, National Department of Health, Pretoria; and Division of Clinical Pharmacology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

Full Text

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Keywords

Trastuzumab; HER2; Breast cancer; Essential Medicines List; Duration of therapy

Cite this article

South African Medical Journal 2020;110(4):271-273. DOI:10.7196/SAMJ.2020.v110i4.14621

Article History

Date submitted: 2020-03-30
Date published: 2020-03-30

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