title: The risk of toxicities from trastuzumab, alone or in combination, in an elderly breast cancer population.
abstract: BACKGROUND
  Breast cancer in the elderly is associated with high recurrence and death rates, due mostly to undertreatment. Human epidermal growth factor receptor type 2 (HER2) overexpression is infrequent in older patients. Trastuzumab-based chemotherapy is often withheld from elderly patients because of its cardiotoxicity.
  
  
  METHODS
  Medical records of consecutive HER2-positive breast cancer patients aged ≥70 years old treated between 2005 and 2010 in the participating centers were retrospectively reviewed. All patients underwent multidimensional geriatric assessment (MGA).
  
  
  RESULTS
  Among 59 patients identified, 51 patients were evaluable (median age 76 years). The rate of any adverse event was 20% (10/51). The most relevant cardiac adverse event consisted of symptomatic congestive heart failure (CHF; n = 1, 2%) followed by asymptomatic decreases of left ventricular ejection fraction (LVEF; n = 6, 12%). Other toxicities included moderate hypersensitivity reactions during trastuzumab infusions (n = 3, 6%). Hypertension, obesity, prior anthracyclines exposure and concurrent chemotherapy were associated with a higher incidence of toxic events. Previous radiotherapy, concurrent endocrine therapy and different trastuzumab-based regimens did not seem to influence toxicity.
  
  
  CONCLUSIONS
  Our data suggest that trastuzumab has a good safety profile in nonfrail women aged 70 years and older. These favorable findings may be related to a limited number of anthracycline pretreatments, patient selection and a close cardiologic monitoring.
authors: Department of Human Pathology, Medical Oncology Unit, University of Messina, Messina, Italy.
authors: Vincenzo
authors: V
authors: Adamo
authors: Giuseppina Rosaria Rita
authors: GR
authors: Ricciardi
authors: Barbara
authors: B
authors: Adamo
authors: Giuseppa
authors: G
authors: Ferraro
authors: Tindara
authors: T
authors: Franchina
authors: Rosalba
authors: R
authors: Rossello
authors: Mariangela
authors: M
authors: Zanghì
authors: Giuseppe
authors: G
authors: Cicero
authors: Sergio
authors: S
authors: Rizzo
authors: Nicola
authors: N
authors: Caristi
authors: Antonio
authors: A
authors: Russo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000737:chemistry / Q000188:drug therapy*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D012189:Retrospective Studies; D000068878:Trastuzumab; D016277:Ventricular Function, Left
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human