Incidence of Heart Failure from Herceptin does not increase over time

[Joe]

Home > News and Events > Research and Meetings > ASCO Annual Meetings > Breast Cancer Incidence of Heart Failure in Women Receiving Trastuzumab Does Not Increase Over Time June 3, 2007 After five years, the risk of congestive heart failure (CHF) associated with adding trastuzumab (Herceptin) to combination chemotherapy for early-stage breast cancer did not increase, according to a phase III clinical trial from the National Surgical Adjuvant Breast and Bowel Project (NSABP). CHF can cause symptoms such as shortness of breath and a reduction in the heart's pumping ability, as measured by the left ventricular ejection fraction (LVEF). "We are encouraged by these new data showing no additional late heart problems associated with trastuzumab," said lead author Priya Rastogi, MD, Assistant Director of Medical Affairs for the NSABP and Assistant Professor of Medicine at the University of Pittsburgh Cancer Institute in Pennsylvania. "While we still need to check patients closely for side effects to the heart, this is reassuring news for women taking this drug." Trastuzumab works by blocking the human epidermal growth factor receptor 2 (HER2), which is present in unusually high levels in approximately 20% to 25% of women with breast cancer. Previous studies showed that adding trastuzumab to chemotherapy for women with early-stage HER2-positive breast cancer lowered the risk of the return of breast cancer by 52% after three years compared with chemotherapy alone. One of these studies from the NSABP showed that the occurrence of CHF at three years was 4% for the women taking trastuzumab, compared with 0.8% of women who did not receive trastuzumab. As part of the NSABP clinical trial, women with HER2-positive breast cancer that had spread to the lymph nodes received either doxorubicin (Adriamycin, Rubex) and cyclophosphamide (Cytoxan, Neosar), followed by paclitaxel (Taxol), or the same treatment plus trastuzumab. The occurrence of CHF was compared between the two groups (1, 850 women in total). After five years, the occurrence of CHF remained at 4% for the women who received trastuzumab. The researchers also observed an improvement in LVEF over time among women in the trastuzumab group who experienced an initial decline in heart function. What This Means for Patients In this study, heart failure occurred in 4% of women with breast cancer who were treated with trastuzumab. Some factors that increased a woman's risk of heart failure included being age 50 or older, a low to normal LVEF, and high blood pressure. Women with breast cancer should talk with their doctors about their risk factors for heart problems to help make appropriate breast cancer treatment decisions.

[CindyE]

Good news! Thanks for sharing this information.

[novakoski]

First message from me.

Appreciate the update. Original cancer diagnosed 8-00, before Herceptin approved by FDA for early HER-2+ cancers. Went through the whole gamut of neoadjuvant chemo, partial mastectomy on right, no positive nodes, radiation. Couldn't take aromatase inhibitors, so thought was cancer free for 3 years till recurrence showed up in 4-04 with mets to 2 mediastinal nodes. Underwent bilateral mastectomies (left one my choice--why play Russian Roulette with boobs?). Got bumped
up" from Stage IIA to Stage IV because of the mets. Herceptin started along with Taxotere and Carboplatin for the first 6 months. After that was on Herceptin weekly for 3 years till 6-07 with NED the entire time. Oncologist decided to take off Herceptin after 3 years, wait and watch. After only 4 months off Herceptin, had superficial recurrence along original mastectomy incision line with no local or distant spread, so resumed the Herceptin along with Abraxane ( new form of Taxol) weekly 1-28-08.

Have always found the Herceptin far more tolerable than any of the other drugs I've taken. Hope it continues to hold. Tests will tell.

Thanks for being there.

[CindyE]

Hello Novakoski,

Sounds like the Herceptin worked well before so it's great you're back on it. We'll all be holding a good thought that it works to kick this cancer out again. Take care,

Cindy

[novakoski]

Thanks, Cindy, for the positive thoughts and wishes. Am scheduled for an operative biopsy for a mass along my original mastectomy incision line on Monday 6-9. My surgical ocologist doesn't really think much about it, but neither of us thought much about the 2 masses in the same area last December and they turned out positive for adenocarcinoma consistent with the primary. I had been off Herceptin for over 6 months at the time. After so many years with this accursed disease, I tend to get paranoid about anything out of the ordinary and consider all masses guilty until proven otherwise.

Sounds as though you have great hopes for a positive outcome as you were able to receive the Herceptin right off the bat. When I was first diagnosed in 2000, it wasn't approved by the FDA for first time tumors. I don't waste time or effort wondering what I might have been spared had I been able to receive it on first diagnosis. Important thing is my hope that it hangs in there and I don't become resistant to its positive effects.

I send you good thoughts and my encouragement for your own well being. All us HER2+ folks gotta hang together.

Regards,
Novakoski