Patterns of Care and Adherence to Recommended Timeframes in HER2 Positive Early Breast Cancer Patients at Sunshine Coast University Hospital
| Wednesday, August 13, 2025 |
| 1:53 PM - 1:59 PM |
| Ballroom 2 and 3 |
Overview
Dr Hui Jan Ho
Speaker
Dr Hui Jan Ho
Medical Oncology Advanced Trainee
Queensland Health
Patterns of Care and Adherence to Recommended Timeframes in HER2 Positive Early Breast Cancer Patients at Sunshine Coast University Hospital
Abstract
Background
Neoadjuvant systemic therapy (NAST) is the standard of care for HER2 positive early breast cancer. The Breast Cancer Optimal Care Pathway (BCOCP) recommends commencement of NAST within four weeks of decision to treat, and adjuvant treatment within six weeks of surgery. This study aims to assess concordance of timeframes with BCOCP recommendations and patterns of use of NAST.
Methods
This retrospective audit included patients diagnosed with non-metastatic HER2 positive breast cancer from 2019-2023 who received NAST within the Sunshine Coast Hospital and Health Service. Data was collected from the Cancer Alliance Queensland registry QOOL, chemotherapy prescribing software CHARM, and electronic medical records.
Results
We identified 71 patients with a median age of 58 years. Median time to treatment was 19 days, with 62/71 (87%) patients commencing NAST within the recommended timeframe. In the nine delayed cases, three (33.3%) were due to external circumstances. Patients in Modified Monash Model (MMM) 2 or higher regions had higher rates of delay to NAST compared to those in MMM 1 regions (19% versus 8%).
Of the 26 patients who received adjuvant trastuzumab emtansine, one (3.8%) did not commence treatment within the recommended timeframe due to cardiotoxicity.
53.5% (38/71) of patients received doxorubicin/cyclophosphamide + paclitaxel/trastuzumab (ACTH). One patient (1.4%) received paclitaxel/trastuzumab/pertuzumab (THP) via clinical trial. The remaining patients received docetaxel/carboplatin/trastuzumab (TCH) (16/71, 22.5%), or paclitaxel/trastuzumab (TH) (16/71, 22.5%). Rates of treatment completion were highest with TCH (100%), followed by TH (81.3%), then ACTH (63.2%). Pathological complete response (pCR) was achieved in 62.5%, 55.3% and 50% of those treated with TCH, ACTH, and TH respectively.
Conclusion
Our treatment of patients with HER2 positive breast cancer showed high rates of concordance with BCOCP recommendations. PCR rates were similar to published literature. Patients in regional areas had more delays to NAST, highlighting the need for health equity.
Neoadjuvant systemic therapy (NAST) is the standard of care for HER2 positive early breast cancer. The Breast Cancer Optimal Care Pathway (BCOCP) recommends commencement of NAST within four weeks of decision to treat, and adjuvant treatment within six weeks of surgery. This study aims to assess concordance of timeframes with BCOCP recommendations and patterns of use of NAST.
Methods
This retrospective audit included patients diagnosed with non-metastatic HER2 positive breast cancer from 2019-2023 who received NAST within the Sunshine Coast Hospital and Health Service. Data was collected from the Cancer Alliance Queensland registry QOOL, chemotherapy prescribing software CHARM, and electronic medical records.
Results
We identified 71 patients with a median age of 58 years. Median time to treatment was 19 days, with 62/71 (87%) patients commencing NAST within the recommended timeframe. In the nine delayed cases, three (33.3%) were due to external circumstances. Patients in Modified Monash Model (MMM) 2 or higher regions had higher rates of delay to NAST compared to those in MMM 1 regions (19% versus 8%).
Of the 26 patients who received adjuvant trastuzumab emtansine, one (3.8%) did not commence treatment within the recommended timeframe due to cardiotoxicity.
53.5% (38/71) of patients received doxorubicin/cyclophosphamide + paclitaxel/trastuzumab (ACTH). One patient (1.4%) received paclitaxel/trastuzumab/pertuzumab (THP) via clinical trial. The remaining patients received docetaxel/carboplatin/trastuzumab (TCH) (16/71, 22.5%), or paclitaxel/trastuzumab (TH) (16/71, 22.5%). Rates of treatment completion were highest with TCH (100%), followed by TH (81.3%), then ACTH (63.2%). Pathological complete response (pCR) was achieved in 62.5%, 55.3% and 50% of those treated with TCH, ACTH, and TH respectively.
Conclusion
Our treatment of patients with HER2 positive breast cancer showed high rates of concordance with BCOCP recommendations. PCR rates were similar to published literature. Patients in regional areas had more delays to NAST, highlighting the need for health equity.
Biography
Jan Ho is a final year Medical Oncology Advanced Trainee in Queensland. She has clinical experience across both regional centres and major tertiary hospitals. Her interests include breast cancer, with involvement in related clinical audits and research. She is passionate about education and lifelong learning, and serves as a member of the Queensland Medical Oncology Advanced Trainee Education Committee.
Session Chair
Jessica Smith
Medical Oncologist
Macquarie University Hospital
