Singapore Cancer Network (SCAN) Guidelines for Adjuvant Trastuzumab Use in Early Stage HER2 Positive Breast Cancer

Abstract

Introduction: The SCAN breast cancer workgroup aimed to develop Singapore Cancer Network (SCAN) clinical practice guidelines for adjuvant trastuzumab use in early stage HER2 positive breast cancer. Materials and Methods: The workgroup utilised a modified ADAPTE process to calibrate high quality international evidence-based clinical practice guidelines to our local setting. Results: Five international guidelines were evaluated—those developed by the National Comprehensive Cancer Network (2015), the National Institute of Health and Clinical Excellence (2006, 2009), the European Society of Medical Oncology (2013), the Breast Cancer Disease Site Group in conjunction with the Program in Evidence-Based Care and Cancer Care Ontario (2011) and the Scottish Intercollegiate Guidelines Network (2013). Recommendations on suitable candidacy for adjuvant trastuzumab, whether adjuvant trastuzumab should be given concurrently with a taxane or sequentially after completion of adjuvant chemotherapy, the optimal frequency of cardiac monitoring during adjuvant trastuzumab and the optimal duration of adjuvant trastuzumab were developed. Conclusion: These adapted guidelines form the SCAN Guidelines 2015 for adjuvant trastuzumab use in early stage HER2 positive breast cancer. Key words: Guideline adaptation, Anti-HER2 targeted therapy