College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
J Oncol Pharm Pract. 2024 Sep;30(6):992-998. doi: 10.1177/10781552231193149. Epub 2023 Aug 1.
Patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) typically receive long-term trastuzumab treatment for several years. The aim of our study is to identify the incidence and characterize late-onset cardiotoxicity in patients with HER2-positive MBC receiving trastuzumab-based therapy.
We retrospectively reviewed charts of HER2-positive MBC patients who received >1 year of trastuzumab-based therapy at the Massachusetts General Hospital Cancer Center over three-year period. The primary endpoint was development of trastuzumab-induced cardiotoxicity (TIC). Secondary endpoints included time to TIC development, incidence/duration of trastuzumab interruption due to TIC, incidence of permanent discontinuation of trastuzumab due to TIC, clinic visit, or hospitalization due to TIC.
Thirty-seven patients were included. Mean age was 56 years (range: 33-78 years, SD 9.5). Seven patients received prior doxorubicin and 14 patients received previous or concurrent breast irradiation. Mean duration of trastuzumab-based therapy was 57 months (range: 14-140 months, SD 39.3). Seven patients (18.9%) experienced TIC resulting in treatment interruption for two patients (28 and 78 days). The median time from starting trastuzumab therapy to TIC was 14 months (interquartile range: 11-29.5 months). The mean number of left ventricular ejection fraction (LVEF) assessment completed per year was 2.7 (range: 1.2-6.6, SD 1.1).
Cardiotoxicity occurred in a minority of patients with HER2-positive MBC receiving trastuzumab-based therapy for more than one year. LVEF reductions to below the institutional lower limit of normal and therapy modifications were uncommon.
人表皮生长因子受体 2（HER2）阳性转移性乳腺癌（MBC）患者通常需要接受曲妥珠单抗治疗数年。我们研究的目的是确定接受曲妥珠单抗为基础治疗的 HER2 阳性 MBC 患者迟发性心脏毒性的发生率和特征。
我们回顾性分析了在马萨诸塞州总医院癌症中心接受曲妥珠单抗治疗超过 1 年的 HER2 阳性 MBC 患者的病历。主要终点是曲妥珠单抗引起的心脏毒性（TIC）的发生。次要终点包括 TIC 发生的时间、因 TIC 中断曲妥珠单抗治疗的发生率/持续时间、因 TIC 而永久停用曲妥珠单抗的发生率、因 TIC 就诊或住院的发生率。
共纳入 37 例患者。平均年龄为 56 岁（范围：33-78 岁，标准差 9.5）。7 例患者接受过多柔比星治疗，14 例患者接受过既往或同期乳房照射。曲妥珠单抗治疗的平均持续时间为 57 个月（范围：14-140 个月，标准差 39.3）。7 例（18.9%）患者发生 TIC，导致 2 例患者（28 天和 78 天）中断治疗。从开始曲妥珠单抗治疗到 TIC 的中位时间为 14 个月（四分位距：11-29.5 个月）。每年完成的左心室射血分数（LVEF）评估的平均值为 2.7（范围：1.2-6.6，标准差 1.1）。
在接受曲妥珠单抗治疗超过 1 年的 HER2 阳性 MBC 患者中，少数患者发生心脏毒性。LVEF 降低至机构正常值下限以下和治疗调整并不常见。
