Ozaki Reina, Morimoto Ryota, Kazama Shingo, Hiraiwa Hiroaki, Kondo Toru, Takano Yuko, Kikumori Toyone, Shimokata Tomoya, Kuwatsuka Yachiyo, Bando Yasuko K, Ando Masahiko, Ando Yuichi, Murohara Toyoaki
Department of Cardiology, Nagoya University Graduate School of Medicine Nagoya Japan.
Department of Breast and Endocrine Surgery, Nagoya University Hospital Nagoya Japan.
Circ Rep. 2025 Jul 19;7(9):800-808. doi: 10.1253/circrep.CR-25-0036. eCollection 2025 Sep 10.
Breast cancer is the most common cancer in women. Although anti-human epidermal growth factor receptor 2 (HER2) therapy is effective in patients with HER2-positive breast cancer, it occasionally induces cancer therapy-related cardiac dysfunction (CTRCD). This study aimed to determine the factors associated with CTRCD in patients with HER2-positive breast cancer treated with trastuzumab.
We retrospectively analyzed the data of 286 patients with breast cancer who received trastuzumab. Accordingly, patients were categorized into CTRCD (+) and CTRCD (-) groups to elucidate the factors associated with cardiotoxicity. The median age of patients was 54 years. CTRCD was observed in 13 (4.5%) patients, and 2 (0.7%) patients had severe symptomatic heart failure, with a New York Heart Association class ≥III. All patients with CTRCD had a history of epirubicin use, and patients receiving both trastuzumab and pertuzumab had significantly higher rates of CTRCD (P=0.003); the history of pertuzumab administration was an independent predictor of CTRCD development. The median duration from trastuzumab initiation to CTRCD onset and from CTRCD onset to recovery was 244 (interquartile range [IQR] 164-333) and 122 ([IQR] 38-186) days, respectively.
In HER2-positive breast cancer, CTRCD occurred more frequently in patients using anthracycline followed by trastuzumab and pertuzumab simultaneously. Systolic dysfunction was reversible in all patients, and normalization of cardiac function took approximately 4 months from CTRCD onset.
乳腺癌是女性中最常见的癌症。尽管抗人表皮生长因子受体2（HER2）治疗对HER2阳性乳腺癌患者有效，但它偶尔会诱发癌症治疗相关的心脏功能障碍（CTRCD）。本研究旨在确定接受曲妥珠单抗治疗的HER2阳性乳腺癌患者中与CTRCD相关的因素。
我们回顾性分析了286例接受曲妥珠单抗治疗的乳腺癌患者的数据。据此，将患者分为CTRCD（+）组和CTRCD（-）组，以阐明与心脏毒性相关的因素。患者的中位年龄为54岁。13例（4.5%）患者观察到CTRCD，2例（0.7%）患者出现严重症状性心力衰竭，纽约心脏协会分级≥III级。所有发生CTRCD的患者都有使用表柔比星的病史，同时接受曲妥珠单抗和帕妥珠单抗治疗的患者CTRCD发生率显著更高（P=0.003）；帕妥珠单抗给药史是CTRCD发生的独立预测因素。从开始使用曲妥珠单抗到CTRCD发作的中位持续时间以及从CTRCD发作到恢复的中位持续时间分别为244天（四分位间距[IQR]164 - 333）和122天（IQR 38 - 186）。
在HER2阳性乳腺癌中，同时使用蒽环类药物后再使用曲妥珠单抗和帕妥珠单抗的患者中CTRCD更频繁发生。所有患者的收缩功能障碍都是可逆的，心脏功能从CTRCD发作开始约4个月恢复正常。
