Trastuzumab-induced cardiotoxicity in early breast cancer patients: a retrospective study of possible risk and protective factors.
Heart
; 99(9): 634-9, 2013 May.
Article
em En
| MEDLINE
| ID: mdl-23349345
ABSTRACT
OBJECTIVE:
Although adjuvant trastuzumab improves survival in patients with HER2-positive early breast cancer, there is growing concern about the long-term effect of trastuzumab-induced cardiotoxicity (TIC). We retrospectively assessed the incidence of TIC and heart failure (HF) to identify possible risk and protective factors.DESIGN:
Retrospective study.SETTING:
Institute for Cancer Research and Treatment, Medical Oncology Department. PATIENTS Consecutive patients who started adjuvant trastuzumab between 2007 and 2010. MAINOUTCOME:
Measures TIC was defined as an absolute left ventricular ejection fraction (LVEF) decrease ≥ 15 points from baseline or a LVEF<50%. Logistic regression was used to estimate OR and their 95% CI in order to evaluate the risk of TIC, considering potential cardiac risk factors (hypertension, hypercholesterolaemia, diabetes mellitus, smoke, cardiac ischaemia and previous chest radiotherapy) and protective factors (ß-blockers, ACE inhibitors and/or angiotensin receptor blockers).RESULTS:
Among 179 patients, 78 cases of TIC (44%, 95% CI 37% to 51%) and four cases of HF (2%, 95% CI 0% to 4%) were reported. 14 patients stopped trastuzumab as a result of TIC. None of the cardiac risk factors or concomitant cardiovascular medications altered the risk of TIC. A previous cumulative dose >240 mg/m(2) of doxorubicin or >500 mg/m(2) of epirubicin increased the risk of TIC compared with lower doses (OR 3.07; 95% CI 1.29 to 7.27, p=0.0011).CONCLUSIONS:
TIC is a frequent, albeit generally mild, adverse event in clinical practice. Further studies are warranted to better define the risk of and protective factors for TIC.
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Assunto principal:
Neoplasias da Mama
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Anticorpos Monoclonais Humanizados
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Cardiopatias
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Antibióticos Antineoplásicos
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Antineoplásicos
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article