Indexé dans
- Ouvrir la porte J
- Genamics JournalSeek
- Clés académiques
- JournalTOCs
- RechercheRef
- Université Hamdard
- EBSCO AZ
- Catalogue en ligne SWB
- Publions
- Fondation genevoise pour la formation et la recherche médicales
- Pub européen
- Google Scholar
Liens utiles
Partager cette page
Dépliant de journal
Revues en libre accès
- Agriculture et aquaculture
- Alimentation et nutrition
- Biochimie
- Bioinformatique et biologie des systèmes
- Business & Management
- Chimie
- Génétique et biologie moléculaire
- Immunologie & Microbiologie
- Ingénierie
- La science des matériaux
- Neurosciences & Psychologie
- Science générale
- Sciences cliniques
- Sciences environnementales
- Sciences médicales
- Sciences pharmaceutiques
- Sciences vétérinaires
- Soins infirmiers et soins de santé
Abstrait
Factors Affecting Long-Term Safety of Trastuzumab in Patients with Early HER2-Positive Breast Cancer
Boekhout AH, Werkhoven ED, Liebergen R, Korse CM, Burylo A, Trip AK, Beijnen JH and Schellens JH
Background: Trastuzumab treatment is associated with cardiac dysfunction. We evaluated the incidence of cardiotoxicity during and long-term after trastuzumab treatment in an unselected early breast cancer population.
Methods: This study included a retrospective part, the chemotherapy- and trastuzumab treatment period and a prospective part, the period of data collection long-term after trastuzumab treatment. Cardiac evaluation included left ventricular ejection fraction (LVEF) changes and an evaluation of symptomatic cardiotoxicity. Cardiac events were defined as a decrease of 10 percentage points in LVEF compared with baseline and to an absolute LVEF of below 50%. Secondary outcomes included the evaluation of cardiac markers (B-type natriuretic peptide and troponins) and single nucleotide polymorphisms (SNPs) in the HER2 gene as parameters to detect or predict trastuzumab-related cardiotoxicity.
Results: Overall, 105 patients were evaluable for the primary endpoint. The 3-year cumulative incidence of cardiac events was 12% (95 CI, 4%-19%). All 8 patients with a cardiac event were pre-treated with anthracyclines and cyclophosphamide and 7 of them recovered partially or completely. Four patients experienced symptomatic cardiotoxicity, of who 2 recovered completely and the other 2 recovered partially. No statistically significant association was observed between cardiac events and cardiac markers or SNPs.
Conclusion: Trastuzumab treatment in combination with anthracy
cline-based chemotherapy is associated with significant and only partly reversible cardiac dysfunction. Baseline LVEF value is a prominent predictor for long-term LVEF especially, in patients who are not treated with anthracycline-based chemotherapy. These findings can be used to establish optimal monitoring strategies in trastuzumab treatment.