Cardiovascular adverse effects of trastuzumab in patients with stage IV breast cancer Meeting Abstract
| Authors: | Keefe, D. L.; Spaltro, B.; Pierri, M. K. |
| Abstract Title: | Cardiovascular adverse effects of trastuzumab in patients with stage IV breast cancer |
| Meeting Title: | 2001 Annual Meeting of the American Society for Clinical Pharmacology and Therapeutics (ASCPT) |
| Abstract: | Unexpected cardiac toxicity with symptomatic heart failure (CHF) due to systolic dysfunction was noted during development of trastuzumab (tz) and confirmed by analysis of the clinical trial data-base. Recent evidence suggests that the HER2 receptor is important in cardiac development and myocyte protection in times of stress, and tz is a monoclonal antibody to HER2. The pharmacy database was used to identify all 210 women with metastatic breast cancer treated with tz at MSKCC since its approval in 1998. Treatment duration was 28±24 (mean±SD) weeks. 42% had received doxorubicin at a dose of 313±237 mg/m2 (mean±SD). 11 of 157 women with ejection fraction data developed a fall of ≥5 points to less than 50%. Four had received doxorubicin (all at ≥400mg/m2), 1 mitoxantrone, and 4 had impaired left ventricular function at baseline. Four patients had clinical CHF-2 mild. Four have died of breast cancer and none of heart failure. These falls in EF occurred at 1 to 28 months (median 5). During tz therapy 14 patients had pericardial effusions, 4 were moderate to large and 1 had tamponade while 3 had a history of tamponade before starting tz. During follow up 10 patients had significant pulmonary hypertension (tricuspid gradient ≥30 mm Hg on echo), 6 while on tz. In conclusion cardiovascular complications are common in patients with advanced breast cancer. Symptomatic CHF occurred in 2% on tz and responded to conventional therapy. However, systolic dysfunction is more common, occurring in 7%, primarily in patients heavily pretreated with anthracyclines, those with pre-existing systolic dysfunction, and those over 65. 10 of 11 patients with systolic dysfunction had ≥1 of these risk factors and 4 had 2. |
| Journal Title: | Clinical Pharmacology & Therapeutics |
| Volume: | 69 |
| Issue: | 2 |
| Meeting Dates: | 2001 Mar 6-10 |
| Meeting Location: | Orlando, FL |
| ISSN: | 0009-9236 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2001-02-01 |
| Start Page: | P6 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 11246718 |
| DOI: | 10.1016/S0009-9236(01)90087-6a |
| DOI/URL: | |
| Notes: | Meeting Abstract: PI-21 -- Export Date: 21 May 2015 -- Source: Scopus |
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