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Published on: August 18, 2023
Cardiotoxicity associated with trastuzumab in normal clinical practice
C Vicente1, N Serrano, M J Agustín
1Servicio de Farmacia, Hospital Universitario Miguel Servet, Zaragoza, España. cvicente@salud.aragon.es
Summary
Cardiotoxicity from trastuzumab treatment for HER2-positive breast cancer occurred in 32.8% of patients, often manifesting as symptomatic dyspnea. This highlights a significant clinical challenge in managing this common adverse effect.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Trastuzumab is a key treatment for HER2-positive breast cancer.
- Cardiotoxicity is a known but potentially underestimated side effect of trastuzumab therapy.
- Understanding real-world incidence and characteristics of trastuzumab-induced cardiotoxicity is crucial for patient management.
Purpose of the Study:
- To determine the incidence of cardiotoxicity in patients receiving trastuzumab in a clinical setting.
- To describe the clinical presentation, progression, and risk factors associated with trastuzumab-related cardiotoxicity.
- To evaluate the impact of cardiotoxicity on treatment continuation.
Main Methods:
- Retrospective observational study of 61 patients with HER2-positive breast cancer treated with trastuzumab.
- Data collected from pharmacy records (Oncowin®) and patient clinical histories.
- Follow-up from treatment initiation to March 2008, assessing baseline characteristics, treatment details, and safety events.
Main Results:
- Cardiotoxicity was observed in 19 patients (32.8%), making it the second most frequent adverse event.
- The average onset time was 7 months, with a mean decrease in left ventricular ejection fraction (LVEF) of 15.6 points.
- Symptomatic cardiotoxicity occurred in 63.2% of affected patients, primarily presenting as dyspnea; treatment was suspended in 22.9% of all patients.
Conclusions:
- The incidence of cardiotoxicity associated with trastuzumab in clinical practice is higher than previously reported.
- Trastuzumab-induced cardiotoxicity presents a significant clinical challenge, impacting treatment decisions for HER2-positive breast cancer.
- Further strategies are needed for optimal management and monitoring of cardiotoxicity in patients receiving trastuzumab.
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