Vol 72, No 5 (2022)
Research paper (original)
Published online: 2022-08-26

open access

Page views 3834
Article views/downloads 268
Get Citation

Connect on Social Media

Connect on Social Media

Cardiotoxicity in patients with early breast cancer treated with adjuvant trastuzumab

Joanna Kufel-Grabowska1, Sławomir Katarzyński2, Sebastian Szmit3, Mikołaj Bartoszkiewicz4, Maria Litwiniuk5
Nowotwory. Journal of Oncology 2022;72(5):288-293.

Abstract

Introduction.Breast cancer is the most common cancer among women in Poland. The aim of this study was to evalu­ate the incidence of cardiotoxicity in patients treated with adjunctive trastuzumab, as well as to determine risk factors for cardiotoxicity.

Material and methods.The study covered 100 patients who completed one year of trastuzumab therapy or discon­tinued treatment due to acute cardiac complications. They underwent an oncological, cardiological, questionnaire and laboratory follow-up.

Results.Acute cardiac complications (CC(+)) occurred in 11 (11%) patients. Patients in the CC(+) group were more likely to have hypertension, ischemic heart disease, hypothyroidism, and were more likely to smoke compared to the gro­up without cardiac complications (CC(–)). They had a lower left ventricular ejection fraction before, during and after trastuzumab therapy, and larger left ventricular dimensions in systole and diastole after treatment. The CC(+) received a higher dose of anthracyclines compared to CC(–). The NT-proBNP value remained elevated in the CC(+) group after treatment, despite normal LVEF values, and was higher than in the CC(–) group.

Conclusions.Based on the study, type II cardiotoxicity, diagnosed early and treated appropriately, was found to be reversible.

Article available in PDF format

View PDF Download PDF file

References

  1. Fahad Ullah M. Breast Cancer: Current Perspectives on the Disease Status. Adv Exp Med Biol. 2019; 1152: 51–64.
  2. Nicolazzi MA, Carnicelli A, Fuorlo M, et al. Anthracycline and trastuzumab-induced cardiotoxicity in breast cancer. Eur Rev Med Pharmacol Sci. 2018; 22(7): 2175–2185.
  3. Serrano C, Cortés J, De Mattos-Arruda L, et al. Trastuzumab-related cardiotoxicity in the elderly: a role for cardiovascular risk factors. Ann Oncol. 2012; 23(4): 897–902.
  4. Pein F, Sakiroglu O, Dahan M, et al. Cardiac abnormalities 15 years and more after adriamycin therapy in 229 childhood survivors of a solid tumor at the Institue Gustave Roussy. Br J Cancer. 2004; 91: 37–44.
  5. Opolski G, Krzakowski M, Szmit S, et al. Task Force of National Consultants in Cardiology and Clinical Oncology. [Recommendations of National Team of Cardiologic and Oncologic Supervision on cardiologic safety of patients with breast cancer. The prevention and treatment of cardiovascular complications in breast cancer. The Task Force of National Consultants in Cardiology and Clinical Oncology for the elaboration of recommendations of cardiologic proceeding with patients with breast cancer]. Kardiol Pol. 2011; 69(5): 520–530.
  6. Zamorano JL, Lancellotti P, Rodriguez MD, et al. ESC Scientific Document Group. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC) . Eur Heart J. 2016; 37(36): 2768–2801.
  7. Herrmann J, Lenihan D, Armenian S, et al. Defining cardiovascular toxicities of cancer therapies: an International Cardio-Oncology Society (IC-OS) consensus statement. Eur Heart J. 2022; 43(4): 280–299.
  8. López-Sendón J, Álvarez-Ortega C, Zamora Auñon P, et al. Classification, prevalence, and outcomes of anticancer therapy-induced cardiotoxicity: the CARDIOTOX registry. Eur Heart J. 2020; 41(18): 1720–1729.
  9. Lyon AR, Dent S, Stanway S, et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. 2020; 22(11): 1945–1960.
  10. Čelutkienė J, Pudil R, López-Fernández T, et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC). Eur J Heart Fail. 2020; 22(9): 1504–1524.
  11. Pudil R, Mueller C, Čelutkienė J, et al. Role of serum biomarkers in cancer patients receiving cardiotoxic cancer therapies: a position statement from the Cardio-Oncology Study Group of the Heart Failure Association and the Cardio-Oncology Council of the European Society of Cardiology . Eur J Heart. 2020; 22(11): 1966–1983.
  12. Joensuu H, Kellokumpu-Lehtinen PL, Bono P, et al. Adjuvant docetaxel or vinorelbine with or without trastuzumab for breast cancer. N Eng J Med. 2006; 354(9): 809–820.
  13. Brouwer CAJ, Gietema JA, van den Berg MP, et al. Long-term cardiac follow-up in survivors of a malignant bone tumour. Ann Oncol. 2006; 17(10): 1586–1591.
  14. Naumann D, Russius V, Margiotta C, et al. Factors predicting trastuzumab-related cardiotoxicity in a real-world population of women with HER2 breast cancer. Anticancer Res. 2013; 33(4): 1717–1720.
  15. Slamon D, Eiermann W, Robert N, et al. Breast Cancer International Research Group. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med. 2011; 365(14): 1273–1283.
  16. Slamon D, Eirmann W, Robert N, et al. Adjuvant trastuzumab in HER2-positive breast cancer. N Engl J Med. 2011; 365: 1273–83.
  17. Russo G, Cioffi G, Do Le, et al. Role of renal function on the development of cardiotoxicity. Intern Emerg Med. 2012; 7(5): 439–446.
  18. Grela-Wojewoda A, Niemiec J, Sas-Korczyńska B, et al. Adjuvant combined therapy with trastuzumab in patients with HER2 positive breast cancer and cardiac alterations: implications for optimal cardio oncology care. Pol Arch Intern Med. 2022; 132(4): 16204.



Nowotwory. Journal of Oncology