Key result
Concurrent administration of trastuzumab with adjuvant hypofractionated radiotherapy (46 Gy, 39 Gy, or 35 Gy) resulted in low rates of grade 2 cardiotoxicity (13%, 0%, and 5%, respectively).
Why the study?
Does concurrent hypofractionated radiotherapy and trastuzumab increase cardiotoxicity in patients with early HER2+ breast cancer?
Cohort (n=52)
Does concurrent hypofractionated radiotherapy and trastuzumab increase cardiotoxicity in patients with early HER2+ breast cancer?
Concurrent administration of hypofractionated radiotherapy and trastuzumab appears safe with no severe (Grade 3) cardiotoxicity observed, regardless of breast side or specific hypofractionation scheme.
Supports concurrent trastuzumab with hypofractionated RT without grade 3 cardiotoxicity; hypothesis-generating and requires randomized confirmation.
AIM: To evaluate cardiotoxicity in patients with human epidermal growth factor receptor 2+ (HER2+) breast cancer (29 left-sided, 23 right-sided) treated with adjuvant whole-breast hypofractionated radiotherapy (HRT) concurrently administered with the humanized monoclonal antibody to HER2, trastuzumab. PATIENTS AND METHODS: From February 2008 to June 2017, 52 patients received three-dimensional conformal RT, with different HRT schemes. Echocardiogram monitoring was used to evaluate the decrease in left ventricular ejection fraction (LVEF). RESULTS: At a median follow-up of 5 years, cardiotoxicity was as follows: among the 15 patients treated with 46 Gy: grade (G) 2 in two (13%), G1 in three (20%), and G0 in 10 (67%);in those treated with 39 Gy (16 patients): G1 in five (31%), and G0 in 11 (69%);among the 21 patients treated with 35 Gy: G2 in one (5%), G1 in five (24%), and G0 in 15 (71%). CONCLUSION: Trastuzumab was shown to be a safe adjuvant treatment when administered with concomitant HRT since it did not increase cardiotoxicity in those with left-sided breast cancer. No differences in LVEF were observed between the HRT schemes.
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Bonzano et al. (2018) conducted a cohort in HER2+ early breast cancer (n=52). Adjuvant whole-breast hypofractionated radiotherapy (HRT) concurrently with trastuzumab vs. Different HRT schemes was evaluated on Cardiotoxicity (decrease in left ventricular ejection fraction). Concurrent administration of trastuzumab with adjuvant hypofractionated radiotherapy (46 Gy, 39 Gy, or 35 Gy) resulted in low rates of grade 2 cardiotoxicity (13%, 0%, and 5%, respectively).
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