Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, Korea.
Department of Pharmacy, National Cancer Center, Goyang-si, 10408, Korea.
Med Oncol. 2017 Nov 21;34(12):199. doi: 10.1007/s12032-017-1041-z.
Trastuzumab is a drug used for the treatment of metastatic breast cancer patients. Due to blockage of the human epidermal growth factor receptor 2 signaling in cardiac myocytes, cardiotoxicity has been observed. There are many studies that investigated risk factors for trastuzumab-induced cardiotoxicity, but no study has been published for factors on the time to cardiotoxicity. This study aimed to investigate the factors for the time to occur trastuzumab-induced cardiotoxicity. From January 2014 to December 2015, a retrospective study was performed with breast cancer patients who were treated with trastuzumab. Associations between presence of and time to cardiotoxicity and various factors were analyzed. Based on multivariate models, it was found that baseline left ventricular ejection fraction (LVEF) < 62.5% (AHR 5.96, 95% CI 2543-13.95) and anthracycline-based chemotherapy (AHR 7.90, 95% CI 1.05-59.71) were significant factors for time to cardiotoxicity after adjusting other confounding factors. Multivariate analysis also showed that BMI ≥ 23 kg/m and baseline LVEF value < 62.5% increased cardiotoxicity 3.0 and 6.6 times, respectively. Our study showed that BMI ≥ 23 kg/m, LVEF < 62.5%, and anthracycline-based chemotherapy were associated with time to trastuzumab-induced cardiotoxicity. Thus, close monitoring of cardiac function is recommended especially for patients using the above risk factors.
曲妥珠单抗是一种用于治疗转移性乳腺癌患者的药物。由于阻断了心肌细胞中的人表皮生长因子受体 2 信号，观察到了心脏毒性。有许多研究调查了曲妥珠单抗引起的心脏毒性的危险因素，但没有研究发表过关于心脏毒性时间的因素。本研究旨在探讨曲妥珠单抗引起的心脏毒性时间的相关因素。从 2014 年 1 月至 2015 年 12 月，对接受曲妥珠单抗治疗的乳腺癌患者进行了回顾性研究。分析了心脏毒性的存在和发生时间与各种因素之间的关系。基于多变量模型，发现基线左心室射血分数（LVEF）<62.5%（AHR 5.96，95%CI 2543-13.95）和蒽环类药物化疗（AHR 7.90，95%CI 1.05-59.71）是调整其他混杂因素后发生心脏毒性时间的重要因素。多变量分析还表明，BMI≥23kg/m2和基线 LVEF 值<62.5%分别使心脏毒性的风险增加 3.0 倍和 6.6 倍。本研究表明，BMI≥23kg/m2、LVEF<62.5%和蒽环类药物化疗与曲妥珠单抗引起的心脏毒性时间有关。因此，建议对使用上述危险因素的患者进行密切的心脏功能监测。
