Cardiotoxicity Induced by Trastuzumab Therapy in HER2-positive Breast Cancer

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Trastuzumab therapy appears to be a safe treatment option for patients with asymptomatic treatment-induced cardiotoxicity (left ventricular ejection fraction [LVEF] of ≥50%), according to an article published online in the journal The Oncologist.

The authors studied patients with HER2-positive breast cancer who were administered adjuvant trastuzumab between 2005 and 2010.

An absolute decrease in LVEF of greater than or equal to 10% to below 55% or an absolute decline of greater than or equal to 16% was the definition of treatment-induced cardiotoxicity for this study.

Results showed 92 out of 573 (16%) patients developed trastuzumab treatment-induced cardiotoxicity. Thirty-one of these 92 patients were able to continue receiving trastuzumab without interruption—all patients were asymptomatic at cardiotoxicity diagnosis (LVEF of ≥50%) with a median LVEF of 53% (range, 50%–63%), and no patients were reported to have developed heart failure during follow-up.

Furthermore, treatment-induced cardiotoxicity related risk factors included age (P =0.011), anthracycline chemotherapy (P =0.002), and lower pretrastuzumab LVEF (P<0.001).

Increased mammography screening can lead to overdiagnosis.
Trastuzumab therapy appears to be a safe treatment option for patients with asymptomatic treatment-induced cardiotoxicity.
Departments of Medicine and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA Correspondence: Anthony F. Yu, M.D., Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, New York 10021, USA. Telephone: 212-639-7932; E-Mail: yua3{at}mskcc.org Received March 24, 2015. Accepted June 8, 2015. Published online before print August 3, 2015.
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