Trastuzumab-related cardiotoxicity in early breast cancer: A cohort study

Martina Bonifazi, Matteo Franchi, Marta Rossi, Lorenzo Moja, Alberto Zambelli, Antonella Zambon, Giovanni Corrao, Carlo La Vecchia, Carlo Zocchetti, Eva Negri

Research output: Contribution to journalArticle

Abstract

Background. Concerns have been raised about the cardiac safety profile of trastuzumab for the adjuvant treatment of early stage breast cancer in clinical practice. We assessed tras- tuzumab-related cardiotoxicity and its predictors in a large co-hort of Italian women. Methods. Through a record linkage between four regional health care databases, we identified the rate of severe car-diac adverse events among women treated with trastu-zumab for early breast cancer in Lombardy. The cumulative risk of cardiotoxicity was estimated using the Kaplan-Meier method, and independent predictors were assessed using the Cox model. Results. Of 2,046 trastuzumab users, 53 (2.6%) experienced at least one hospitalization for a cardiac event, and there were two cardiac deaths. The cumulative risk of cardiotoxicity in- creased up to 2 years after starting treatment, reaching a pla-teau at 2.8%. The risk was low (0.2%) among young women, whereas the incidence was approximately 10% in women aged >70 years, irrespective of cardiovascular risk factors. Age and history of cardiac disease were strong predictors of cardiotoxicity, with a hazard ratio of 11.3 (95% confidence in-terval [CI]: 3.5-36.6) for women aged >70 years as compared with those

Original languageEnglish
Pages (from-to)795-801
Number of pages7
JournalThe oncologist
Volume18
Issue number7
DOIs
Publication statusPublished - 2013

Fingerprint

Cohort Studies
Breast Neoplasms
Proportional Hazards Models
Heart Diseases
Hospitalization
Cardiotoxicity
Trastuzumab
Databases
Delivery of Health Care
Safety
Incidence
Therapeutics

Keywords

  • Adjuvant chemotherapy
  • Cardiotoxicity
  • Early breast cancer
  • Survival
  • Trastuzumab

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Bonifazi, M., Franchi, M., Rossi, M., Moja, L., Zambelli, A., Zambon, A., ... Negri, E. (2013). Trastuzumab-related cardiotoxicity in early breast cancer: A cohort study. The oncologist, 18(7), 795-801. https://doi.org/10.1634/theoncologist.2013-0065

Trastuzumab-related cardiotoxicity in early breast cancer : A cohort study. / Bonifazi, Martina; Franchi, Matteo; Rossi, Marta; Moja, Lorenzo; Zambelli, Alberto; Zambon, Antonella; Corrao, Giovanni; La Vecchia, Carlo; Zocchetti, Carlo; Negri, Eva.

In: The oncologist, Vol. 18, No. 7, 2013, p. 795-801.

Research output: Contribution to journalArticle

Bonifazi, M, Franchi, M, Rossi, M, Moja, L, Zambelli, A, Zambon, A, Corrao, G, La Vecchia, C, Zocchetti, C & Negri, E 2013, 'Trastuzumab-related cardiotoxicity in early breast cancer: A cohort study', The oncologist, vol. 18, no. 7, pp. 795-801. https://doi.org/10.1634/theoncologist.2013-0065
Bonifazi, Martina ; Franchi, Matteo ; Rossi, Marta ; Moja, Lorenzo ; Zambelli, Alberto ; Zambon, Antonella ; Corrao, Giovanni ; La Vecchia, Carlo ; Zocchetti, Carlo ; Negri, Eva. / Trastuzumab-related cardiotoxicity in early breast cancer : A cohort study. In: The oncologist. 2013 ; Vol. 18, No. 7. pp. 795-801.
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