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Factors for time to trastuzumab-induced cardiotoxicity in breast cancer patients

Mi Hyung Lee1,2, Jeong Yee3, Young Ju Kim2

  • 1Graduate School of Converging Clinical & Public Health, Ewha Womans University, Seoul, 03760, Korea.

Medical Oncology (Northwood, London, England)
|November 23, 2017
PubMed

Insights

Trastuzumab-induced cardiotoxicity risk factors include a baseline left ventricular ejection fraction below 62.5% and anthracycline chemotherapy. Body mass index over 23 kg/m² also increases risk, necessitating cardiac monitoring.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Trastuzumab is a targeted therapy for HER2-positive metastatic breast cancer.
  • Trastuzumab can cause cardiotoxicity by blocking HER2 signaling in cardiac cells.
  • Previous studies identified risk factors for trastuzumab cardiotoxicity, but not for the timing of its onset.

Purpose of the Study:

  • To investigate factors influencing the time to cardiotoxicity in breast cancer patients treated with trastuzumab.
  • To identify predictive markers for early-onset trastuzumab-induced cardiac dysfunction.

Main Methods:

  • Retrospective study of breast cancer patients treated with trastuzumab from January 2014 to December 2015.
  • Analysis of associations between various patient factors and the time to cardiotoxicity.
  • Multivariate models used to adjust for confounding variables and determine significant predictors.

Main Results:

  • Lower baseline left ventricular ejection fraction (LVEF) < 62.5% was a significant predictor (AHR 5.96).
  • Anthracycline-based chemotherapy significantly increased the risk of cardiotoxicity (AHR 7.90).
  • Higher BMI (≥ 23 kg/m²) also correlated with increased cardiotoxicity risk (3.0 times).

Conclusions:

  • Baseline LVEF < 62.5%, anthracycline chemotherapy, and BMI ≥ 23 kg/m² are associated with the time to trastuzumab-induced cardiotoxicity.
  • Close cardiac monitoring is crucial for patients with these risk factors.
  • Further research may refine risk stratification for trastuzumab cardiotoxicity.
Keywords:
Breast cancerLeft ventricular ejection fractionTime to cardiotoxicityTrastuzumab

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