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Use and outcomes of targeted therapies in early and metastatic HER2-positive breast cancer in Australia: protocol detailing observations in a whole of population cohort
  1. Benjamin Daniels1,
  2. Sarah J Lord2,3,
  3. Belinda E Kiely3,
  4. Nehmat Houssami4,
  5. Philip Haywood5,
  6. Christine Y Lu6,
  7. Robyn L Ward7,
  8. Sallie-Anne Pearson1
  9. On behalf of the HER2 therapy observational study (HER2-OBS) investigators
  1. 1Medicines Policy Research Unit, Centre for Big Data Research in Health, UNSW, Sydney, New South Wales, Australia
  2. 2School of Medicine, University of Notre Dame Australia, Sydney, New South Wales, Australia
  3. 3NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
  4. 4Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  5. 5Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia
  6. 6Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
  7. 7University of Queensland, Brisbane, Queensland, Australia
  1. Correspondence to Professor Sallie-Anne Pearson; sallie.pearson{at}unsw.edu.au

Abstract

Background The management of human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC) has changed dramatically with the introduction and widespread use of HER2-targeted therapies. However, there is relatively limited real-world information on patterns of use, effectiveness and safety in whole of population cohorts. The research programme detailed in this protocol will generate evidence on the prescribing patterns, safety monitoring and outcomes of patients with BC treated with HER2-targeted therapies in Australia.

Methods/design Our ongoing research programme will involve a series of retrospective cohort studies that include every patient accessing Commonwealth-funded HER2-targeted therapies for the treatment of early BC and advanced BC in Australia. At the time of writing, our cohorts consist of 11 406 patients with early BC and 5631 with advanced BC who accessed trastuzumab and lapatinib between 2001 and 2014. Pertuzumab and trastuzumab emtansine were publicly funded for metastatic BC in 2015, and future data updates will include patients accessing these medicines. We will use dispensing claims for cancer and other medicines, medical service claims and demographics data for each patient accessing HER2-targeted therapies to undertake this research.

Ethics and dissemination Ethics approval has been granted by the Population Health Service Research Ethics Committee and data access approval has been granted by the Australian Department of Human Services (DHS) External Review Evaluation Committee. Our findings will be reported in peer-reviewed publications, conference presentations and policy forums. By providing detailed information on the use and outcomes associated with HER2-targeted therapies in a national cohort treated in routine clinical care, our research programme will better inform clinicians and patients about the real-world use of these treatments and will assist third-party payers to better understand the use and economic costs of these treatments.

  • HER2
  • breast cancer
  • trastuzumab
  • observational study
  • pharmacoepidemiology

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Collaborators HER2 therapy observational study (HER2-OBS) investigators.

  • Contributors BD, SJL, BEK, NH, PH, CYL, RLW and S-AP conceived of the study protocol. BD, RLW and S-AP contributed to the acquisition of the data. BD conducted the literature search and performed the data analyses. BD, SJL, BEK, NH, PH, CYL, RLW and S-AP contributed to the design of the work and interpretation of the data.

  • Funding This research is supported, in part, by a Cancer Australia Priority Driven Collaborative Support Scheme (ID: 1050648) and funding from the NHMRC Centre of Research Excellence in Medicines and Ageing (CREMA; ID: 1060407). BD is supported by an NHMRC Postgraduate Research Scholarship (ID: 1094325), the Sydney Catalyst Translational Cancer Research Centre and a CREMA PhD scholarship top-up.

  • Competing interests BEK has received conference support and a speaker's honorarium from Roche.

  • Ethics approval Population Health Service Research Ethics Committee (approval number: 2010/02/213) and Australian Department of Human Services (DHS) External Review Evaluation Committee (approval numbers: MI1474, MI1475 and MI1477).

  • Provenance and peer review Not commissioned; externally peer reviewed.