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KMID : 1011320190110020096
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Journal of Pharmacoepidemiology and Risk Management
2019 Volume.11 No. 2 p.96 ~ p.101
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Incidence of Pertuzumab Induced Diarrhea and Its Pharmacological Treatment Pattern in a Real Clinical Practice
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Park So-Hyun
Park Seol-Hee
Shin Eun-Jeong
Kim Sung-Hwan
Suh Sung-Yun
Jo Yun-Hee
Cho Yoon-Sook
Im Seock-Ah
Lee Ju-Yeun
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Abstract
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Objective: Although the combination of trastuzumab with pertuzumab showed better therapeutic efficacy, the adverse events were relatively higher than trastuzumab monotherapy. We aimed to identify the incidence and pharmacological management pattern of the pertuzumab induced diarrhea in a real-world clinical practice.
Methods: This retrospective study included 178 patients diagnosed with HER2-positive breast cancer and treated with either docetaxel, trastuzumab (control group, n=92) or docetaxel, trastuzumab, pertuzumab (±carboplatin) (pertuzumab group, n=86) as neoadjuvant or metastatic treatment between 2014 and 2017 at Seoul National University Hospital. The primary outcome was the incidence of pertuzumab induced diarrhea compared with control group.
Results: The incidence of diarrhea in the pertuzumab group was significantly higher than the control group (75.6% vs. 16.3%, p＜0.001). Pertuzumab induced diarrhea occurred more frequently in the first cycle than the other cycles. Antidiarrheal medications, mostly loperamide, were prescribed in 62.8% (54/86) of patients and 26.4% (151/573) of cycles with pertuzumab. The prevalence of preemptive prescription of antidiarrheals in the first cycle was relatively low. In multivariate analysis, we could not find associated factors with pertuzumab induced diarrhea other than chemotherapy cycle administered.
Conclusion: This study showed that the incidence of diarrhea in pertuzumab group were significantly higher than control group, especially in the first cycle, in real world practice. When treating breast cancer patients with pertuzumab, awareness of diarrhea and careful management plan is needed.
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KEYWORD
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Adverse events, Breast cancer, Diarrhea, Incidence, Pertuzumab
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