Background Trastuzumab is the main treatment of HER-2 positive breast cancer. Its administration intravenously has shown an extension of survival not only in early stage but also in advance stage tumours. With the inclusion of subcutaneous formulations, medical resources in this field have been implemented. Length of stay in the day hospital has been shortened and patients’ quality of life has improved.
Purpose To compare administration of trastuzumab intravenously versus subcutaneously. Analysing the security profile and effectiveness, and also the associated costs, and preferences and quality of life for patients.
Material and methods We changed administration of trastuzumab intravenously to subcutaneously in all patients with a diagnosis of breast cancer HER-2 positive during 2015. All adverse effects associated with the administration were registered. We also analysed its efficiency by testing the response to treatment, and we surveyed patients about their preferences. Finally we calculated the savings generated by the change of administration to subcutaneous.
Results A total of six patients were treated with trastuzumab subcutaneously, all of them had previously been treated with intravenous formulations. The dose given in each subcutaneous cycle was 600 mg. The average number of cycles given was 30.
Efficiency was not compromised by subcutaneous administration as there were no relapses during or after treatment. Concerning security associated with the administration of the intravenous formulation, only adverse reactions grade 2 were observed (hives and chills) in one patient (16.6%); these stopped after administration of 100 mg actocortin. There were no adverse reactions with subcutaneous administration of trastuzumab in any of the patients.
In the survey of preference of administration, subcutaneous was preferred in 100% of cases.
Administration of the medication subcutaneously led to savings of 1891.8 Euros per patient and per whole treatment (7 cycles) compared with intravenous medication.
Conclusion Administration of subcutaneous trastuzumab provided major advantages compared with intravenous administration as it reduced time of administration, saved sanitary costs and improved the life quality of patients without endangering effectiveness and safety of the treatment.
No conflict of interest.
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