Camejo-Martínez Natalia, Castillo-Leska Cecilia, Rodríguez-Saenz Valeria, Herrera-Álvarez Guadalupe, Amarillo-Hernández Dahiana, Dörner-Cabrera María Carolina, Krygier-Waltier Gabriel
Universidad de la República, Facultad de Medicina, Servicio de Oncología Clínica. Montevideo, Uruguay.
Universidad de la República, Facultad de Medicina, Departamento de Métodos Cuantitativos. Montevideo, Uruguay.
Rev Med Inst Mex Seguro Soc. 2024 Jan 8;62(1):1-7. doi: 10.5281/zenodo.10278147.
HER-2 positive (+) breast cancer (BC) accounts for 20-25% of BC, it is more aggressive, and it has a lower survival rate. Since the approval of trastuzumab in 1998, other HER-2-targeted therapies such as pertuzumab and trastuzumab emtansine (TDM1) have been introduced, improving patient survival. However, cardiotoxicity is an adverse effect of these treatments.
To estimate the incidence of cardiotoxicity with trastuzumab, trastuzumab/pertuzumab, and TDM1 in women with HER-2 + BC treated over a 6-year period at the Hospital de Clínicas and the Hospital Departamental de Soriano.
Observational, descriptive, and retrospective study which included patients with HER-2 + BC treated with trastuzumab, trastuzumab/pertuzumab, or TDM1.
81 patients were included, with a cardiotoxicity incidence of 23.4%. Cardiotoxicity was determined by a > 10% decrease in left ventricular ejection fraction (LVEF) (57.9%) and a LVEF < 50% evident during treatment (42.1%). Only 1 patient presented symptomatic heart failure. 63.1% of those who discontinued treatment due to cardiotoxicity managed to resume it. No relationship was evident between cardiovascular history or the administration regimen and the development of cardiotoxicity.
The study showed a cardiotoxicity incidence similar to the international one. Most did not present cardiac toxicity, and if they did, it was asymptomatic and reversible.
人表皮生长因子受体2（HER-2）阳性（+）乳腺癌（BC）占乳腺癌的20%-25%，侵袭性更强，生存率更低。自1998年曲妥珠单抗获批以来，其他HER-2靶向治疗药物如帕妥珠单抗和曲妥珠单抗 emtansine（TDM1）相继问世，提高了患者生存率。然而，心脏毒性是这些治疗的一种不良反应。
评估在临床医院和索里亚诺省医院接受治疗的6年期间，HER-2 + BC女性患者使用曲妥珠单抗、曲妥珠单抗/帕妥珠单抗和TDM1时心脏毒性的发生率。
一项观察性、描述性和回顾性研究，纳入接受曲妥珠单抗、曲妥珠单抗/帕妥珠单抗或TDM1治疗的HER-2 + BC患者。
纳入81例患者，心脏毒性发生率为23.4%。心脏毒性通过左心室射血分数（LVEF）下降>10%（57.9%）以及治疗期间LVEF<50%明显降低（42.1%）来确定。仅1例患者出现症状性心力衰竭。因心脏毒性停药的患者中，63.1%得以恢复用药。心血管病史或给药方案与心脏毒性的发生之间无明显关联。
该研究显示心脏毒性发生率与国际水平相似。大多数患者未出现心脏毒性，若出现，多为无症状且可逆的。
