Trastuzumab-targeted therapy significantly increased the 5-year risk of cardiotoxicity compared to conventional chemotherapy in patients with early breast cancer (OR 4.69).
Cohort (n=415)
No
Does trastuzumab-targeted therapy and/or anthracyclines increase the incidence of cardiotoxic events in patients with early breast cancer compared to conventional chemotherapy?
In patients with early breast cancer, cumulative anthracycline use of >4 cycles, trastuzumab use, and radiotherapy independently increased 5-year cardiotoxicity, while a Tei index >0.40 predicted early subclinical injury.
Odds Ratio: 4.69 (95% CI 2.41–9.11)
Absolute Event Rate: 23% vs 12.7%
p-value: p=<0.001
Objective: To investigate the cardiotoxicity of breast cancer (BC) chemotherapy drugs and analyse their risk factors. Methods: Through the electronic medical record system, the data of 415 patients with early BC (EBC) who had undergone a complete chemotherapy cycle were retrospectively collected within 5 years from the beginning of chemotherapy. Baseline clinical, biochemical and echocardiographic data were retrospectively extracted for comparative analysis. Results: The incidence of cardiotoxic events in patients with EBC receiving trastuzumab-targeted therapy was as high as 23%, which was significantly higher than that in the conventional chemotherapy group (P = 0.006). The incidence of cardiotoxicity in patients receiving conventional chemotherapy combined with targeted therapy increased year by year. The use of anthracyclines or trastuzumab significantly increased the risk of cardiotoxicity, especially when the two drugs were used in combination, showing a significant synergistic effect (P 4, radiotherapy, use of trastuzumab, abnormal myocardial zymogram and elevated troponin I (TnI) levels were identified as risk factors for cardiotoxicity. The Tei index increased over time (P 4 cycles, trastuzumab use and radiotherapy independently increased 5-year cardiotoxicity (adjusted odds ratio >3), whereas a Tei index of >0.40 predicted early subclinical injury with an AUC of 0.867. The cardiotoxicity associated with targeted therapy drugs, represented by trastuzumab, is mostly asymptomatic left ventricular ejection fraction reduction and shows a synergistic effect with anthracyclines. During chemotherapy, the Tei index was more accurate in evaluating myocardial injury.
Ju et al. (2025) conducted a cohort in Early Breast Cancer (n=415). Trastuzumab-targeted therapy vs. Conventional chemotherapy was evaluated on Incidence of cardiotoxic events within 5 years (OR 4.69, 95% CI 2.41-9.11, p=<0.001). Trastuzumab-targeted therapy significantly increased the 5-year risk of cardiotoxicity compared to conventional chemotherapy in patients with early breast cancer (OR 4.69).