Trastuzumab-related cardiotoxicity in the elderly

A role for cardiovascular risk factors

C. Serrano, J. Cortés, L. De Mattos-Arruda, M. Bellet, P. Gómez, C. Saura, J. Pérez, M. Vidal, E. Muñoz-Couselo, M. J. Carreras, G. Sánchez-Ollé, J. Tabernero, J. Baselga, S. Di Cosimo

Research output: Contribution to journalArticle

94 Citations (Scopus)

Abstract

Background: Elderly breast cancer patients are usually excluded from clinical trials. Nevertheless, with the increasing use of trastuzumab, there is a need to address trastuzumab-related cardiotoxicity in this population. Patients and methods: Records for patients ≥70 years treated with trastuzumab since 2005 were reviewed. New York Heart Association classification was used to document symptomatic cardiotoxicity. Asymptomatic cardiotoxicity was defined as an absolute drop ≥10% with a final left ventricular ejection fraction 20%. Results: Forty-five patients, median age 75.9 years (range 70-92), were identified. Three of 24 (12.5%) early breast cancer patients and 5 of 21 (23.8%) with advanced disease experienced asymptomatic cardiotoxicity. Four of 45 patients (8.9%), all with advanced breast cancer, developed symptomatic congestive heart failure. All but one of them recovered in a median time of 5 weeks (range 3-21). Patients with trastuzumab-related cardiotoxicity presented more often with cardiovascular risk factors, such as history of cardiac disease (33% versus 9.1%, P = 0.017) and diabetes (33.3% versus 6.1%, P = 0.010), compared with those without. Conclusions: Elderly breast cancer patients with a history of cardiac disease and/or diabetes treated with trastuzumab have an increased incidence of cardiotoxicity. Continuous cardiac monitoring is especially advised in this population.

Original languageEnglish
Pages (from-to)897-902
Number of pages6
JournalAnnals of Oncology
Volume23
Issue number4
DOIs
Publication statusPublished - Apr 2012

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Breast Neoplasms
Heart Diseases
Asymptomatic Diseases
Cardiotoxicity
Trastuzumab
Stroke Volume
Population
Heart Failure
Clinical Trials
Incidence

Keywords

  • Breast cancer
  • Cardiotoxicity
  • Elderly
  • HER-2 overexpression
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Hematology

Cite this

Serrano, C., Cortés, J., De Mattos-Arruda, L., Bellet, M., Gómez, P., Saura, C., ... Di Cosimo, S. (2012). Trastuzumab-related cardiotoxicity in the elderly: A role for cardiovascular risk factors. Annals of Oncology, 23(4), 897-902. https://doi.org/10.1093/annonc/mdr348

Trastuzumab-related cardiotoxicity in the elderly : A role for cardiovascular risk factors. / Serrano, C.; Cortés, J.; De Mattos-Arruda, L.; Bellet, M.; Gómez, P.; Saura, C.; Pérez, J.; Vidal, M.; Muñoz-Couselo, E.; Carreras, M. J.; Sánchez-Ollé, G.; Tabernero, J.; Baselga, J.; Di Cosimo, S.

In: Annals of Oncology, Vol. 23, No. 4, 04.2012, p. 897-902.

Research output: Contribution to journalArticle

Serrano, C, Cortés, J, De Mattos-Arruda, L, Bellet, M, Gómez, P, Saura, C, Pérez, J, Vidal, M, Muñoz-Couselo, E, Carreras, MJ, Sánchez-Ollé, G, Tabernero, J, Baselga, J & Di Cosimo, S 2012, 'Trastuzumab-related cardiotoxicity in the elderly: A role for cardiovascular risk factors', Annals of Oncology, vol. 23, no. 4, pp. 897-902. https://doi.org/10.1093/annonc/mdr348
Serrano C, Cortés J, De Mattos-Arruda L, Bellet M, Gómez P, Saura C et al. Trastuzumab-related cardiotoxicity in the elderly: A role for cardiovascular risk factors. Annals of Oncology. 2012 Apr;23(4):897-902. https://doi.org/10.1093/annonc/mdr348
Serrano, C. ; Cortés, J. ; De Mattos-Arruda, L. ; Bellet, M. ; Gómez, P. ; Saura, C. ; Pérez, J. ; Vidal, M. ; Muñoz-Couselo, E. ; Carreras, M. J. ; Sánchez-Ollé, G. ; Tabernero, J. ; Baselga, J. ; Di Cosimo, S. / Trastuzumab-related cardiotoxicity in the elderly : A role for cardiovascular risk factors. In: Annals of Oncology. 2012 ; Vol. 23, No. 4. pp. 897-902.
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abstract = "Background: Elderly breast cancer patients are usually excluded from clinical trials. Nevertheless, with the increasing use of trastuzumab, there is a need to address trastuzumab-related cardiotoxicity in this population. Patients and methods: Records for patients ≥70 years treated with trastuzumab since 2005 were reviewed. New York Heart Association classification was used to document symptomatic cardiotoxicity. Asymptomatic cardiotoxicity was defined as an absolute drop ≥10{\%} with a final left ventricular ejection fraction 20{\%}. Results: Forty-five patients, median age 75.9 years (range 70-92), were identified. Three of 24 (12.5{\%}) early breast cancer patients and 5 of 21 (23.8{\%}) with advanced disease experienced asymptomatic cardiotoxicity. Four of 45 patients (8.9{\%}), all with advanced breast cancer, developed symptomatic congestive heart failure. All but one of them recovered in a median time of 5 weeks (range 3-21). Patients with trastuzumab-related cardiotoxicity presented more often with cardiovascular risk factors, such as history of cardiac disease (33{\%} versus 9.1{\%}, P = 0.017) and diabetes (33.3{\%} versus 6.1{\%}, P = 0.010), compared with those without. Conclusions: Elderly breast cancer patients with a history of cardiac disease and/or diabetes treated with trastuzumab have an increased incidence of cardiotoxicity. Continuous cardiac monitoring is especially advised in this population.",
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AU - Bellet, M.

AU - Gómez, P.

AU - Saura, C.

AU - Pérez, J.

AU - Vidal, M.

AU - Muñoz-Couselo, E.

AU - Carreras, M. J.

AU - Sánchez-Ollé, G.

AU - Tabernero, J.

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AU - Di Cosimo, S.

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N2 - Background: Elderly breast cancer patients are usually excluded from clinical trials. Nevertheless, with the increasing use of trastuzumab, there is a need to address trastuzumab-related cardiotoxicity in this population. Patients and methods: Records for patients ≥70 years treated with trastuzumab since 2005 were reviewed. New York Heart Association classification was used to document symptomatic cardiotoxicity. Asymptomatic cardiotoxicity was defined as an absolute drop ≥10% with a final left ventricular ejection fraction 20%. Results: Forty-five patients, median age 75.9 years (range 70-92), were identified. Three of 24 (12.5%) early breast cancer patients and 5 of 21 (23.8%) with advanced disease experienced asymptomatic cardiotoxicity. Four of 45 patients (8.9%), all with advanced breast cancer, developed symptomatic congestive heart failure. All but one of them recovered in a median time of 5 weeks (range 3-21). Patients with trastuzumab-related cardiotoxicity presented more often with cardiovascular risk factors, such as history of cardiac disease (33% versus 9.1%, P = 0.017) and diabetes (33.3% versus 6.1%, P = 0.010), compared with those without. Conclusions: Elderly breast cancer patients with a history of cardiac disease and/or diabetes treated with trastuzumab have an increased incidence of cardiotoxicity. Continuous cardiac monitoring is especially advised in this population.

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