Skip to main content
Erschienen in: Journal of Cancer Research and Clinical Oncology 8/2018

05.06.2018 | Original Article – Clinical Oncology

Trastuzumab-induced cardiotoxicity and its risk factors in real-world setting of breast cancer patients

verfasst von: Tiina Moilanen, Anna Jokimäki, Olli Tenhunen, Jussi P. Koivunen

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Cardiotoxicity is the most important side effect of trastuzumab treatment. Heart function monitoring is recommended during the treatment which has led to growing use of resources. The aim of this retrospective study was to determine the frequency and timing of trastuzumab cardiotoxicity and its risk factors in real-world setting.

Methods

Single institute, retrospective collection of data on HER2+ breast cancer patients (n = 246) was carried out through a pharmacy search for patients who had received trastuzumab in 2006–2014. Clinical and pathological factors, treatment history, EF measurements, cardiac medications, cardiovascular disease history, cardiac symptoms, and survival data were collected from patient records.

Results

32 patients (13%) had EF decline ≥ 10%, eleven (4.5%) had EF decline ≥ 20% within 1 year after trastuzumab initiation, and trastuzumab was discontinued due to suspected cardiotoxicity in six patients (2.4%). 49 patients (19.9%) experienced symptoms related to cardiotoxicity during therapy, which accumulated among those with EF drop. Underlying cardiovascular diseases and multiple (≥ 2) cardiac medications were related to EF drop (≥ 20%) and trastuzumab discontinuation. Majority of EF drops (≥ 10%) and trastuzumab discontinuations were seen within 6months of trastuzumab initiation and recovery of EF drop to < 10% of the baseline was seen in most cases (62.5%). There was no statistically significant difference in the survival of patients according to EF drop.

Conclusions

Trastuzumab cardiotoxicity seems to accumulate among patients with underlying cardiac conditions. EF monitoring could be targeted to risk groups without compromising of the cardiac health or survival of HER2-positive breast cancer patients.
Literatur
Zurück zum Zitat Kaufman B, Mackey JR, Clemens MR, Bapsy PP, Vaid A, Wardley A et al (2009) Trastuzumab plus anastrozole versus anastrozole alone for the treatment of postmenopausal women with human epidermal growth factor receptor 2–Positive, hormone Receptor–Positive metastatic breast cancer: Results from the randomized phase III TAnDEM study. 27(33):5529–5537. https://doi.org/10.1200/JCO.2008.20.6847 Kaufman B, Mackey JR, Clemens MR, Bapsy PP, Vaid A, Wardley A et al (2009) Trastuzumab plus anastrozole versus anastrozole alone for the treatment of postmenopausal women with human epidermal growth factor receptor 2–Positive, hormone Receptor–Positive metastatic breast cancer: Results from the randomized phase III TAnDEM study. 27(33):5529–5537. https://​doi.​org/​10.​1200/​JCO.​2008.​20.​6847
Zurück zum Zitat Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235(4785):177–182CrossRefPubMed Slamon DJ, Clark GM, Wong SG, Levin WJ, Ullrich A, McGuire WL (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235(4785):177–182CrossRefPubMed
Zurück zum Zitat Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE et al (1989) Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science 244(4905):707–712CrossRefPubMed Slamon DJ, Godolphin W, Jones LA, Holt JA, Wong SG, Keith DE et al (1989) Studies of the HER-2/neu proto-oncogene in human breast and ovarian cancer. Science 244(4905):707–712CrossRefPubMed
Zurück zum Zitat von Minckwitz G, du Bois A, Schmidt M, Maass N, Cufer T, de Jongh FE et al (2009) Trastuzumab beyond progression in human epidermal growth factor receptor 2–Positive advanced breast cancer: A german breast group 26/breast international group 03–05 study. 27(12):1999–2006. https://doi.org/10.1200/JCO.2008.19.6618 von Minckwitz G, du Bois A, Schmidt M, Maass N, Cufer T, de Jongh FE et al (2009) Trastuzumab beyond progression in human epidermal growth factor receptor 2–Positive advanced breast cancer: A german breast group 26/breast international group 03–05 study. 27(12):1999–2006. https://​doi.​org/​10.​1200/​JCO.​2008.​19.​6618
Metadaten
Titel
Trastuzumab-induced cardiotoxicity and its risk factors in real-world setting of breast cancer patients
verfasst von
Tiina Moilanen
Anna Jokimäki
Olli Tenhunen
Jussi P. Koivunen
Publikationsdatum
05.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 8/2018
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-018-2682-9

Weitere Artikel der Ausgabe 8/2018

Journal of Cancer Research and Clinical Oncology 8/2018 Zur Ausgabe

Umsetzung der POMGAT-Leitlinie läuft

03.05.2024 DCK 2024 Kongressbericht

Seit November 2023 gibt es evidenzbasierte Empfehlungen zum perioperativen Management bei gastrointestinalen Tumoren (POMGAT) auf S3-Niveau. Vieles wird schon entsprechend der Empfehlungen durchgeführt. Wo es im Alltag noch hapert, zeigt eine Umfrage in einem Klinikverbund.

CUP-Syndrom: Künstliche Intelligenz kann Primärtumor finden

30.04.2024 Künstliche Intelligenz Nachrichten

Krebserkrankungen unbekannten Ursprungs (CUP) sind eine diagnostische Herausforderung. KI-Systeme können Pathologen dabei unterstützen, zytologische Bilder zu interpretieren, um den Primärtumor zu lokalisieren.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.