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 journalArticlepeer-review


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
Issue number4
Publication statusPublished - Apr 2012


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

ASJC Scopus subject areas

  • Oncology
  • Hematology

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