Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu-pulsed dendritic cell vaccines.
BACKGROUND
Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity.


METHODS
Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function.


RESULTS
In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses.


CONCLUSIONS
This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function.
Department of Surgery, Rena Rowan Breast Center, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
Susan
S
Bahl
Robert E
RE
Roses
Anupama
A
Sharma
Ursula
U
Koldovsky
Shuwen
S
Xu
Susan
S
Weinstein
Harvey
H
Nisenbaum
Kevin
K
Fox
Theresa
T
Pasha
Paul
P
Zhang
Louis
L
Araujo
Joseph
J
Carver
Brian J
BJ
Czerniecki
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000628:therapy*; D019496:Cancer Vaccines / Q000009:adverse effects*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000628:therapy*; D003713:Dendritic Cells; D005260:Female; D018734:Genes, erbB-2; D006801:Humans; D008875:Middle Aged; D013318:Stroke Volume; D018754:Ventricular Dysfunction / Q000209:etiology / Q000503:physiopathology*
D019496:Cancer Vaccines