TY - JOUR
T1 - Cardiac toxicity of trastuzumab in metastatic breast cancer patients previously treated with high-dose chemotherapy
T2 - A retrospective study
AU - Bengala, C.
AU - Zamagni, C.
AU - Pedrazzoli, P.
AU - Matteucci, P.
AU - Ballestrero, A.
AU - Da Prada, G.
AU - Martino, M.
AU - Rosti, G.
AU - Danova, M.
AU - Bregni, M.
AU - Jovic, G.
AU - Guarneri, V.
AU - Maur, M.
AU - Conte, P. F.
PY - 2006/4/10
Y1 - 2006/4/10
N2 - HER-2 overexpression is associated to a poor prognosis in high-risk and metastatic breast cancer (MBC) patients treated with high-dose chemotherapy (HDC). HER-2 status is also a predictive factor and when trastuzumab is administered in combination with or sequentially to chemotherapy, a significant disease-free and/or overall survival improvement has been observed in HER-2 + early and MBC. Unfortunately, in both settings, trastuzumab is associated with an increased risk of cardiac dysfunction (CD). We have reviewed the clinical charts of HER-2-overexpressing MBC patients treated with trastuzumab after HDC. Age, baseline left ventricular ejection fraction (LVEF), radiation therapy on cardiac area, exposure to anthracycline, single or multiple transplant, high-dose agents, trastuzumab treatment duration were recorded as potential risk factors. In total, 53 patients have been included in the analysis. Median LVEF at baseline was 60.5%; at the end of trastuzumab (data available for 28 patients only), it was 55% (P = 0.01). Five out of the 28 (17.9%) patients experienced CD. Two out of 53 (3.8%) patients developed a congestive heart failure. Age ≥50 years and multiple transplant procedure were potential risk factors for CD. The overall incidence of CD observed in this population of HER-2+ MBC patients treated with trastuzumab after HDC is not superior to that reported with concomitant trastuzumab and anthracyclines. However, patients with age ≥50 years or receiving multiple course of HDC should be considered at risk for CD.
AB - HER-2 overexpression is associated to a poor prognosis in high-risk and metastatic breast cancer (MBC) patients treated with high-dose chemotherapy (HDC). HER-2 status is also a predictive factor and when trastuzumab is administered in combination with or sequentially to chemotherapy, a significant disease-free and/or overall survival improvement has been observed in HER-2 + early and MBC. Unfortunately, in both settings, trastuzumab is associated with an increased risk of cardiac dysfunction (CD). We have reviewed the clinical charts of HER-2-overexpressing MBC patients treated with trastuzumab after HDC. Age, baseline left ventricular ejection fraction (LVEF), radiation therapy on cardiac area, exposure to anthracycline, single or multiple transplant, high-dose agents, trastuzumab treatment duration were recorded as potential risk factors. In total, 53 patients have been included in the analysis. Median LVEF at baseline was 60.5%; at the end of trastuzumab (data available for 28 patients only), it was 55% (P = 0.01). Five out of the 28 (17.9%) patients experienced CD. Two out of 53 (3.8%) patients developed a congestive heart failure. Age ≥50 years and multiple transplant procedure were potential risk factors for CD. The overall incidence of CD observed in this population of HER-2+ MBC patients treated with trastuzumab after HDC is not superior to that reported with concomitant trastuzumab and anthracyclines. However, patients with age ≥50 years or receiving multiple course of HDC should be considered at risk for CD.
KW - Cardiac toxicity
KW - High-dose chemotherapy
KW - Metastatic breast cancer
KW - Trastuzumab
UR - http://www.scopus.com/inward/record.url?scp=33645748115&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33645748115&partnerID=8YFLogxK
U2 - 10.1038/sj.bjc.6603060
DO - 10.1038/sj.bjc.6603060
M3 - Article
C2 - 16570045
AN - SCOPUS:33645748115
VL - 94
SP - 1016
EP - 1020
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 7
ER -