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LETTERS: Matthew L Grove Adjuvant trastuzumab for breast cancer: An increasingly common ethical and economic conundrum BMJ 2005; 331: 1202-b [Full text]

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Erratum

Matthew L Grove   (18 November 2005)

Erratum 18 November 2005
Matthew L Grove, Consultant Rheumatologist NTGH, NE29 8NH Send response to journal: Re: Erratum	In my letter commenting on the NEJM herceptin trials, the wrong trial has been referenced. Two papers were published in the NEJM on 20/10/05; my quick and dirty, back of the envelope NNT calculation is based on that by Romond et al (1), rather than by Piccart et al (2). I apologise for the error; in my original rapid response I did not give a reference, and consequently cannot blame the BMJ for including the wrong one. Incidentally, this accounts for the differences in NNT calculation between my rapid response and those of Gopalakrishnan and McLaren (3). The Piccart-Gebhart paper one year data of 220 deaths /recurrences in 1693 controls compared to 127 in 1694 herceptin treated patients gives an NNT of 18 (95% ci 13-29) and had I taken the time and run the figures for both papers, I would certainly have used this one. The point I wished to make was that the true cost of the drug was far higher than £20K per patient treated, and that not to quote absolute risk reduction misrepresents the benefit; the higher NNT in the second paper makes this point better. (1) Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CG, Davidson NE, et al. Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 2005;353: 1673-84 (2) Piccart-Gebhart MJ, Procter M, Leyland-Jones B, Goldhirsch A, Untch M, Smith I, et al. Trastuzumab after adjuvant chemotherapy in HER2- positive breast cancer. N Engl J Med 2005;353: 1659-72. (3) BMJ Rapid Responses http://bmj.bmjjournals.com/cgi/eletters/331/7524/1035 Competing interests: None declared