Key result
Long-term trastuzumab is linked to a ≥15% LVEF decline in ~5% of breast cancer patients.
Why the study?
The long-term clinical tolerance and cardiac safety of trastuzumab treatment in breast cancer patients with HER2 overexpression required assessment.
Does trastuzumab treatment reduce left ventricular ejection fraction in female patients with HER2-positive breast cancer?
Cohort (n=105)
Does trastuzumab treatment reduce left ventricular ejection fraction in female patients with HER2-positive breast cancer?
Long-term trastuzumab treatment in HER2-positive breast cancer patients is associated with significant but generally well-tolerated decreases in LVEF, with all patients maintaining LVEF >50%.
Supports ongoing LVEF monitoring with long-term trastuzumab; leaves open need for randomized confirmation of cardiotoxicity risks.
BACKGROUND The aim of this study was to assess the long-term clinical tolerance and cardiac safety during trastuzumab treatment for patients diagnosed as having breast cancer with human epidermal growth factor receptor 2 (HER2) overexpression. MATERIAL AND METHODS A total 105 female cases diagnosed as having breast cancer with high expression of Her2, were treated with trastuzumab (T). All of them underwent electrocardiography monitoring in the process of T treatment. Left ventricular ejection fractions (LVEFs) were estimated using echocardiography before the T treatment and every 3 months. General clinical data and above parameters were collected and reviewed as analysis. RESULTS The mean value of LVEFs with baseline was higher than those at other time points. All LVEFs were more than 50% during the course of trastuzumab treatment. The decline scope ≥15% of LVEFs ranged from 2 months to 16 months, and the ratios were counted for 3.1% at 2 months, 4.3% at 6 months, 3.8% at 10 months, and 5.4% at 16 months. Furthermore, a larger decrease of LVEF during the course occurred mainly in the patients with cumulative dose of A >300 mg/m², without CPD and 16-month duration of T treatment. There was a strong correlation between cumulative dose of A, cyto/cardio-protection drugs (CPD), duration of T, and the change of LVEF (P=0.82, P=0.744, and P=0.717, respectively), which indicated that 3 factors may be associated with the change in LVEF (P<0.05). CONCLUSIONS The LVEF in patients with trastuzumab treatment was significantly decreased, which may be seen as a favorable benefit-risk ratio for patients undergoing long-term trastuzumab treatment.
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Sun et al. (2016) conducted a cohort in Breast cancer with HER2 overexpression (n=105). Trastuzumab was evaluated on Decline in LVEF ≥15%. Long-term trastuzumab treatment in HER2-positive breast cancer patients was associated with a ≥15% decline in LVEF in 5.4% of patients at 16 months, though all LVEFs remained >50%.
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