@article{10.11648/j.ijcocr.20261103.13,
  author = {Lordin Alumasa Wanjala and Everisto Opondo and Janai Ondieki and Tracy Irura},
  title = {Predictors of Survival Outcomes of HER2-Positive Breast Cancer Patients at a Tertiary Referral Hospital in Kenya},
  journal = {International Journal of Clinical Oncology and Cancer Research},
  volume = {11},
  number = {3},
  pages = {70-83},
  doi = {10.11648/j.ijcocr.20261103.13},
  url = {https://doi.org/10.11648/j.ijcocr.20261103.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcocr.20261103.13},
  abstract = {Background: HER2-positive breast cancer is an aggressive subtype associated with poor outcomes, particularly in low- and middle-income countries where access to targeted therapy is limited. Despite the growing burden of breast cancer in Kenya, comprehensive data on survival outcomes for HER2-positive patients remain scarce. Objectives: This study aimed to assess survival outcomes, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS), among HER2-positive breast cancer patients treated at Moi Teaching and Referral Hospital (MTRH) in Kenya. Methods: This retrospective cohort study included 300 histologically confirmed HER2-positive breast cancer patients diagnosed between January 2018 and December 2023. Data were extracted from medical records, pathology reports, and treatment charts using a standardized abstraction tool. Kaplan-Meier methods were used to estimate survival outcomes. The log-rank test compared survival distributions between groups. Multivariable Cox proportional hazards regression identified independent predictors of survival. To address the substantial loss to follow-up (38.3%), sensitivity analyses including worst-case, best-case, and inverse probability of censoring weighting (IPCW) were conducted. Results: The 5-year overall survival was 82.3% (95% CI: 76.8–87.1%), with median OS not reached (lower bound 104.0 months). After IPCW adjustment, the 5-year OS estimate was 77.1% (95% CI: 70.4–83.8%). In unadjusted analyses, clinical stage (p=0.014) and metastasis status (p=0.040) were significantly associated with OS. However, in the multivariable Cox regression model, chemotherapy completion was the only statistically significant independent predictor of overall survival (HR=0.41, 95% CI: 0.19–0.89, p=0.024), adjusting for stage, metastasis status, trastuzumab completion, hormone receptor status, and age. Trastuzumab completion showed borderline significance for PFS (HR=0.37, 95% CI: 0.14–1.02, p=0.054). The 5-year DFS was 73.6% (95% CI: 66.8–81.2%). Conclusions: Survival outcomes for HER2-positive breast cancer patients at MTRH are favorable compared to historical regional data, though lower than high-income country benchmarks. Chemotherapy completion is associated with critical determinants of survival. Addressing financial barriers and improving treatment completion are essential to improve outcomes.},
 year = {2026}
}

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TY  - JOUR
T1  - Predictors of Survival Outcomes of HER2-Positive Breast Cancer Patients at a Tertiary Referral Hospital in Kenya
AU  - Lordin Alumasa Wanjala
AU  - Everisto Opondo
AU  - Janai Ondieki
AU  - Tracy Irura
Y1  - 2026/09/28
PY  - 2026
N1  - https://doi.org/10.11648/j.ijcocr.20261103.13
DO  - 10.11648/j.ijcocr.20261103.13
T2  - International Journal of Clinical Oncology and Cancer Research
JF  - International Journal of Clinical Oncology and Cancer Research
JO  - International Journal of Clinical Oncology and Cancer Research
SP  - 70
EP  - 83
PB  - Science Publishing Group
SN  - 2578-9511
UR  - https://doi.org/10.11648/j.ijcocr.20261103.13
AB  - Background: HER2-positive breast cancer is an aggressive subtype associated with poor outcomes, particularly in low- and middle-income countries where access to targeted therapy is limited. Despite the growing burden of breast cancer in Kenya, comprehensive data on survival outcomes for HER2-positive patients remain scarce. Objectives: This study aimed to assess survival outcomes, including overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS), among HER2-positive breast cancer patients treated at Moi Teaching and Referral Hospital (MTRH) in Kenya. Methods: This retrospective cohort study included 300 histologically confirmed HER2-positive breast cancer patients diagnosed between January 2018 and December 2023. Data were extracted from medical records, pathology reports, and treatment charts using a standardized abstraction tool. Kaplan-Meier methods were used to estimate survival outcomes. The log-rank test compared survival distributions between groups. Multivariable Cox proportional hazards regression identified independent predictors of survival. To address the substantial loss to follow-up (38.3%), sensitivity analyses including worst-case, best-case, and inverse probability of censoring weighting (IPCW) were conducted. Results: The 5-year overall survival was 82.3% (95% CI: 76.8–87.1%), with median OS not reached (lower bound 104.0 months). After IPCW adjustment, the 5-year OS estimate was 77.1% (95% CI: 70.4–83.8%). In unadjusted analyses, clinical stage (p=0.014) and metastasis status (p=0.040) were significantly associated with OS. However, in the multivariable Cox regression model, chemotherapy completion was the only statistically significant independent predictor of overall survival (HR=0.41, 95% CI: 0.19–0.89, p=0.024), adjusting for stage, metastasis status, trastuzumab completion, hormone receptor status, and age. Trastuzumab completion showed borderline significance for PFS (HR=0.37, 95% CI: 0.14–1.02, p=0.054). The 5-year DFS was 73.6% (95% CI: 66.8–81.2%). Conclusions: Survival outcomes for HER2-positive breast cancer patients at MTRH are favorable compared to historical regional data, though lower than high-income country benchmarks. Chemotherapy completion is associated with critical determinants of survival. Addressing financial barriers and improving treatment completion are essential to improve outcomes.
VL  - 11
IS  - 3
ER  - 

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