One year of adjuvant trastuzumab is the standard of care for HER2-positive breast cancer. In low–middle income countries, delivery of 1-year trastuzumab is challenging due to significant financial burden. Evidence for shorter durations of adjuvant trastuzumab is gaining popularity in this regard. In this study, we compared the effectiveness and safety of 1 year versus shorter durations of adjuvant trastuzumab practiced in our center. In total, 312 patients were included in this analysis. The median age was 52 years. More than two-thirds of patients (67.6%) had stage 2 disease and majority were hormone-receptor-positive (62.5%). The median follow-up duration was 50 months. The 4-year disease-free survival was 97.3%. The 4-year disease-free survival for shorter durations of adjuvant trastuzumab was 98% compared with 96.7% in 1-year trastuzumab therapy group. In univariate analysis, stage at diagnosis was the only factor which had statistically significant association with disease-free survival. In multivariate analysis, none of the variables were found to be predictive of survival. Two patients (0.6%) had significant left ventricular ejection fraction decline.

Shorter durations of adjuvant trastuzumab have comparable 4-year disease-free survival to standard 1-year therapy and is an alternative adjuvant treatment option for HER2-positive breast cancer patients in resource-limited settings.

N.D.R, P.K.S, and M.A contributed to the project through conceptualization, data curation, formal analysis, investigation, methodology, and both the original draft and review & editing of the writing. A.M and S.S were involved in data curation, formal analysis, investigation, methodology, and writing the original draft, while S.S also participated in writing. B.T contributed by focusing on formal analysis, investigation, methodology, and both the original draft and review & editing of the writing.

Part of this study was presented as POSTER at the 21st Annual Conference of Women Cancer Initiative-Tata Memorial Centre at Mumbai on 01–03–2024.

*Both the authors contributed equally to this article.

Received: 19 March 2024

Accepted: 21 September 2024

Article published online:
06 November 2024

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