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Trastuzumab associated with cardiotoxicity in elderly women with risk factors
Serrano C. Ann Oncol. 2011;doi:10.1093/annonc/mdr348
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Elderly women with breast cancer and a history of heart disease are at a particularly higher risk for heart problems when treated with trastuzumab for their disease, according to data from a recent study.
“Trastuzumab is a current standard of care in HER2-positive breast cancer patients,” Cesar Serrano, MD, clinical fellow at the Department of Medical Oncology Breast Cancer Centre at the Vall d’Hebron University Hospital in Barcelona, Spain, and colleagues wrote in their study. “Although well tolerated, concerns about cardiotoxicity have recently led to a push to identify patients at risk of developing treatment-related cardiac events.”
Serrano and colleagues analyzed data for 45 women aged 70 to 92 years who were treated with trastuzumab (Herceptin, Genentech) since 2005. According to their results, 26.7% of patients developed a treatment-related cardiac event; 17.8% developed asymptomatic left ventricular ejection fraction (LVEF) decline; and 8.9% developed symptomatic congestive heart failure. All patients who developed asymptomatic cardiac events recovered after treatment discontinuation. All but one patient who developed symptomatic congestive heart failure recovered in a median of 5 weeks.
Women with CV risk factors, like history of cardiac disease and diabetes, were more likely to have treatment-related cardiotoxicity: 33% of those with a history of heart disease vs. 9.1% of those without (P=.017) and 33.3% of those with diabetes vs. 6.1% of those without (P=.010).
“Approximately 70% of all newly diagnosed cancers occur in patients older than 65 and, given the expected increase in the absolute number of elderly patients over the coming decades in Western countries, there is an unmet need for information about the efficacy and safety of anti-cancer treatments in daily clinical practice,” Serrano said in a press release. “Data obtained in this report can serve to advise clinicians to be aware of symptomatic and asymptomatic cardiac dysfunction in elderly patients. We think that it is reasonable to refer elderly breast cancer patients to a cardiologist if one or more cardiovascular risk factors are present before or during treatment with trastuzumab. Moreover, a closer surveillance of early symptoms and cardiac function is highly recommended.”
Disclosure: The researchers report no relevant disclosures.
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