title: Long-term tolerance and cardiac function in breast cancer patients receiving trastuzumab therapy.
abstract: We examined the long-term clinical tolerance and cardiac safety of trastuzumab treatment in ninety-four female patients diagnosed with breast cancer with human epidermal growth factor receptor 2 (HER-2) overexpression. Electrocardiography (ECG) was monitored throughout trastuzumab treatment, and left ventricular ejection fractions (LVEFs) were estimated using echocardiography prior to treatment with trastuzumab and every 3 months after its first application. The duration of trastuzumab treatments ranged from 3 to 60 months. Declines in LVEF ≥ 15% were seen mainly after 3-15 months of trastuzumab treatment, and LVEF was lowest at 15 months, which coincided with the largest decline in LVEF from baseline. Spearman correlation coefficients indicated that accumulation of anthracycline, the use of cyto/cardioprotective drugs (CPD) and the duration of trastuzumab treatment were all associated with the change of LVEF, and there was a strong correlation between these factors and the change of LVEF (ρ=0.81, ρ=0.734 and ρ=0.777 respectively). These results indicate that significant decreases of LVEF may be seen after 3-15 months of trastuzumab treatment, but that there is a favorable benefit-risk ratio for patients undergoing long-term trastuzumab treatment.
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Huang
authors.affiliation: Department of Intense Care Unit, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
authors.forename: Shujun
authors.initials: S
authors.lastname: Dai
authors.affiliation: Department of Radiation Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Department of Tumor Comprehensive Treatment, Hangzhou Cancer Hospital, Hangzhou, China.
authors.forename: Yajuan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Zhanhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yabing
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Xiying
authors.initials: X
authors.lastname: Shao
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Lei
authors.affiliation: Department of Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Xiaojia
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D066126:Cardiotoxicity / Q000453:epidemiology; D016903:Drug Monitoring / Q000379:methods; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism; D013997:Time Factors; D000068878:Trastuzumab / Q000009:adverse effects / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000175:diagnosis; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018719:Erb-b2 Receptor Tyrosine Kinases; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Her-2; LVEF; breast cancer; cardiac event; trastuzumab