SC vs IV Trastuzumab/Pertuzumab: A Time and Motion Substudy of a Phase II Trial of Adjuvant Trastuzumab/Pertuzumab for Stage I HER2+ Breast Cancer

鈥� An ASCO Reading Room selection

December 17, 2024

Adrienne G. Waks, MD, Emily L. Chen, MD, Noah Graham, MB, Anna Mae Frey, BA, Kenneth Almeida, PharmD, Victoria Attaya, BA, Cari Ryding, MSN, RN, Ibrahim Abbass, PhD, Anita Fung, PharmD, Jesse Sussell, PhD, Patricia Cortazar, MD, Caroline Harvey, RPh, Denise Leth, CPhT, Meredith Faggen, MD, Natalie Sinclair, MD, Jeanna Walsh, MD, Nadine Tung, MD, Sarah Sinclair, DO, Steve Lo, MD, Denise Yardley, MD, Vicente Valero, MD, FACP, Jane Meisel, MD, Tarah J. Ballinger, MD, Sylvia Adams, MD, Lisa A. Carey, MD, Julia K. Rauch, MD, Vandana G. Abramson, MD, Nicole O. Williams, MD, Wendy Y. Chen, MD, MPH, Jose P. Leone, MD, Susan T. Schumer, MD, Nabihah Tayob, PhD, and Sara M. Tolaney, MD, MPH

JCO Oncology Practice

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Purpose

The time required for in-clinic drug administration can substantially affect breast cancer patients' quality of life. Subcutaneous (SC) drug administration, as opposed to intravenous (IV), may reduce this time commitment. This study sought to estimate the difference in time burden between IV and SC administration of trastuzumab and pertuzumab (HP).

Methods

We prospectively enrolled a subcohort of patients participating in the ADEPT trial (ClinicalTrials.gov identifier: , investigating adjuvant HP plus endocrine therapy for stage I human epidermal growth factor receptor 2–positive breast cancer) to this single-arm crossover time and motion substudy. Patients received two cycles of IV HP followed by two cycles of SC HP. During each cycle, time points in drug preparation and administration were captured. The primary end point was total patient time in the treatment chair. Additional end points included total patient treatment experience time and total pharmacy workflow time. A sample size of 22 patients was estimated to provide 90.7% power with two-sided alpha 0.05 to detect a difference of 70 minutes in the primary end point by treatment arm (IV v SC).

Results

Twenty-two patients were enrolled. The mean total patient time in the treatment chair was 61.8 minutes shorter with SC versus IV HP (22.5 vs 84.3 minutes, P<0.0001). The mean total patient treatment experience time (incorporating time spent waiting for treatment initiation and time spent in the treatment chair) was 81.8 minutes shorter for SC administration (96 vs 177.8 minutes, P<0.0001). The pharmacy workflow time was 78.2 minutes shorter for SC versus IV formulation (41 vs 119.2 minutes, P<0.0001).

Conclusion

SC administration of HP shortened patient time burden by approximately 1 hour. SC drug administration can facilitate faster workflows for healthcare professionals and improve patients' breast cancer treatment experience.

Read an interview about the study here.

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SC vs IV Trastuzumab/Pertuzumab: A Time and Motion Substudy of a Phase II Trial of Adjuvant Trastuzumab/Pertuzumab for Stage I HER2+ Breast Cancer

Primary Source

JCO Oncology Practice

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