October 15, 2013Journal of Clinical Oncology
Trastuzumab-Related Cardiotoxicity Among Older Patients With Breast Cancer
Why the study?
Does trastuzumab increase the risk of congestive heart failure in older patients with breast cancer treated with chemotherapy?
Population
9,535 breast cancer patients at least 66 years old with full Medicare coverage, diagnosed with stage I-III…
Comparison
Trastuzumab added to chemotherapy vs Chemotherapy without trastuzumab
Design
Cohort
Authors
Discussion
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Member takes
Implication
May warrant closer cardiac surveillance in older patients; extends trial data but leaves causal inference open.
Structured PICO
Does trastuzumab increase the risk of congestive heart failure in older patients with breast cancer treated with chemotherapy?
P
Population
9,535 breast cancer patients at least 66 years old with full Medicare coverage, diagnosed with stage I-III breast cancer between 2005 and 2009, and treated with chemotherapy. Median age 71 years.
I
Intervention
Trastuzumab added to chemotherapy
C
Comparator
Chemotherapy without trastuzumab
O
Outcome
Development of congestive heart failure (CHF)safety
In older breast cancer patients, trastuzumab use is associated with a significantly higher rate of congestive heart failure (29.4%) than reported in clinical trials, particularly among those with older age or cardiac comorbidities.
Cite This Study
Chávez‐MacGregor et al. (2013) studied this question.