ArticleBreast cancer research and treatment2026
Anti-HER2 treatment in everyday practice: how we treat older women with breast cancer differently.
Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTargeted therapies have improved survival in human epidermal growth factor receptor 2 positive breast cancer (HER2 + BC). However, patients over 75 years of age are often excluded from clinical trials of anti-HER2 therapies, and it is unclear to what extent they receive these treatments in routine care. To address this, we examined age-related patterns of anti-HER2 therapy use in real-world clinical practice in Norway.
methodsIn a nationwide registry-based cohort, we identified women diagnosed with stage I-III HER2 + BC during 2012-2021. We investigated treatment patterns using descriptive statistics and estimated the direct effect of age on anti-HER2 therapy use by Poisson regression.
resultsAmong 3526 women with HER2 + BC, anti-HER2 therapy use was consistently high (83-95%) in those under 75 years, decreased to 60% at ages 75-79, and declined further with advancing age to 8% at ≥ 90 years. Neoadjuvant anti-HER2 therapy also decreased with age (from 24% in patients under 75 to 12% in patients over 75 years). Accounting for cancer characteristics, comorbidities, polypharmacy, and socio-economic factors, older patients had reduced likelihood of receiving any anti-HER2 therapy compared with patients younger than 55 (RR 0.75, 95% CI 0.66-0.85, p < 0.001, at age 75-84 and RR 0.21, 95% CI 0.11-0.41, p < 0.001, at age 85 +).
conclusionsAnti-HER2 therapy use declined substantially after the age of 75 even when accounting for comorbidities and polypharmacy. Chronological age appears important in planning treatment for patients with HER2 + BC. Specific guidelines pertaining to older patients with HER2 + BC are needed to avoid potential undertreatment.
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