Department of Cardiology, Baskent University School of Medicine, Dr Turgut Noyan Practice and Research Center, Adana, Turkey.
Department of Oncology, Baskent University School of Medicine, Dr Turgut Noyan Practice and Research Center, Adana, Turkey.
J Int Med Res. 2021 Dec;49(12):3000605211053755. doi: 10.1177/03000605211053755.
New anti-cancer drugs promise to increased survival benefits and reduce adverse events. Trastuzumab emtansine (T-DM1) is a novel anti-human epidermal growth factor receptor 2 agent that has shown minimal cardiotoxicity in clinical trials. However, data on real-life outcomes are required.
A retrospective review of our center's medical records was performed, including female patients aged ≥18 years with a diagnosis of metastatic breast cancer who were treated with T-DM1. Descriptive statistics were used to investigate clinical features that could increase the risk of cardiotoxicity. Cardiotoxicity was determined by comparing pre and post-T-DM1 echocardiogram results and was defined as a decrease in the left ventricular ejection fraction (LVEF) >10% to below 55%.
Data from 41 female patients with a mean age of 52 ± 11.5 years were evaluated. A significant LVEF decrease (from 59% to 33%) was observed in one patient during T-DM1 treatment. Further investigation showed that this decrease was due to underlying coronary artery disease, and LVEF recovered to the baseline value after coronary revascularization.
T-DM1 seems to be safe in terms of cardiotoxicity. Real-life data with a larger sample size are still needed to confirm the cardiac safety of T-DM1.
新型抗癌药物有望提高生存获益并减少不良反应。曲妥珠单抗-美坦新偶联物（T-DM1）是一种新型抗人表皮生长因子受体 2 药物，在临床试验中显示出极小的心脏毒性。然而，需要真实世界的数据来证实。
我们对中心的病历进行了回顾性分析，包括接受 T-DM1 治疗的年龄≥18 岁的转移性乳腺癌女性患者。采用描述性统计分析来探讨可能增加心脏毒性风险的临床特征。通过比较 T-DM1 治疗前后的超声心动图结果来确定心脏毒性，心脏毒性定义为左心室射血分数（LVEF）下降>10%至<55%。
评估了 41 名平均年龄为 52±11.5 岁的女性患者的数据。一名患者在 T-DM1 治疗期间观察到 LVEF 显著下降（从 59%降至 33%）。进一步的调查显示，这种下降是由于潜在的冠状动脉疾病引起的，在冠状动脉血运重建后 LVEF 恢复到基线值。
T-DM1 在心脏毒性方面似乎是安全的。仍需要更大样本量的真实世界数据来证实 T-DM1 的心脏安全性。
