Huszno Joanna, Badora Agnieszka, Nowara Elżbieta
Clinical and Experimental Oncology Department, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
Arch Med Sci. 2015 Apr 25;11(2):371-7. doi: 10.5114/aoms.2015.50969. Epub 2015 Apr 23.
Expression of steroid receptors and HER2 overexpression in breast cancer cells are predictive and prognostic factors. Overexpression of HER2 allows the use of immunotherapy, in which the most serious side effect is cardiotoxicity. The aim of this study was to evaluate the influence of steroid receptor status on cardiotoxicity risk in HER2 breast cancer patients receiving trastuzumab both in adjuvant treatment and in the case of disease dissemination. This study also assessed well-known cardiac risk factors.
The study was conducted on 166 patients who received immunotherapy in the Clinical and Experimental Oncology Department, between the years 2006 and 2012.
A predisposition to cardiac side effects (13% vs. 5%) in patients with negative steroid receptor status was observed (p = 0.08). The decrease of left ventricular ejection fraction (LVEF) (12% vs. 0) and cardiac adverse side effects (2% vs. 0) were detected only in ER-/PR- patients but without statistical significance. Discontinuation of therapy because of cardiotoxicity was associated with negative receptor status (33% vs. 7%) (p = 0.019). Irrespective of steroid receptor status, older age of patients (p = 0.009) and previous radiotherapy to the left side of the chest (p = 0.02) were associated with the occurrence of cardiotoxicity and decrease of LVEF. In patients who received previous anthracycline-based chemotherapy, acute cardiac side effects were observed significantly more often (p = 0.01).
There was no influence of steroid receptor status on the cardiac side effects. Breast cancer type containing Erb-B2 overexpression was associated with predisposition to cardiotoxicity. The results require confirmation in a larger group of patients.
乳腺癌细胞中类固醇受体的表达和HER2过表达是预测和预后因素。HER2过表达使得免疫疗法成为可能，其中最严重的副作用是心脏毒性。本研究的目的是评估类固醇受体状态对接受曲妥珠单抗辅助治疗以及疾病播散情况下HER2阳性乳腺癌患者心脏毒性风险的影响。本研究还评估了众所周知的心脏危险因素。
本研究对2006年至2012年间在临床与实验肿瘤学部门接受免疫治疗的166例患者进行。
观察到类固醇受体状态阴性的患者有心脏副作用倾向（13%对5%）（p = 0.08）。仅在雌激素受体/孕激素受体阴性的患者中检测到左心室射血分数（LVEF）下降（12%对0）和心脏不良副作用（2%对0），但无统计学意义。因心脏毒性而停药与受体状态阴性相关（33%对7%）（p = 0.019）。无论类固醇受体状态如何，患者年龄较大（p = 0.009）和先前左侧胸部放疗（p = 0.02）与心脏毒性的发生和LVEF下降相关。在接受过基于蒽环类药物化疗的患者中，急性心脏副作用的发生率明显更高（p = 0.01）。
类固醇受体状态对心脏副作用无影响。含有Erb-B2过表达的乳腺癌类型与心脏毒性倾向相关。结果需要在更大规模的患者群体中得到证实。
