HonCode

Go Back   HER2 Support Group Forums > Articles of Interest
Register Gallery FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools Display Modes
Old 01-24-2020, 07:31 AM   #1
Nguyen
Senior Member
 
Join Date: Nov 2005
Posts: 228
T-DM1–Associated Cardiotoxicity in Advanced HER2-Positive Breast Cancer

T-DM1–Associated Cardiotoxicity in Advanced HER2-Positive Breast Cancer
James Chih-Hsin Yang et. al.,

European Journal of Cancer

TAKE-HOME MESSAGE

This pooled analysis was designed to characterize trastuzumab emtansine (T-DM1)–associated cardiotoxicity among patients with HER2+ breast cancer. The total cardiac event rate was 3.37%, and the majority of events experienced were asymptomatic drops in LVEF. Age ≥65 years was a risk factor for cardiac events. Most cardiac events resolved with discontinuation of T-DM1.

The incidence of cardiac events associated with T-DM1 use in patients with HER2+ breast cancer was low, but older patients should be carefully monitored.

– Neil Majithia MD

INTRODUCTION

T-DM1 has been approved for the treatment of HER2+ breast cancer. Cardiac dysfunction is a side effect of trastuzumab, a component of T-DM1. However, little is known about T-DM1-associated cardiotoxicity.

METHODS

We have conducted a pooled analysis of T-DM1 trials in advanced HER2+ breast cancer cases to understand the incidence, clinical presentation as well as to establish possible risk factors for T-DM1-associated cardiotoxicity. The primary endpoint was the incidence of cardiac events (CEs). CEs were categorized as follows: (1) congestive heart failure (CHF) or grade 3/4 LVEF drop; (2) cardiac ischemia, (3) cardiac arrhythmia, (4) grade 1/2 LVEF drop. Secondary endpoints included CE recovery rate and impact of CEs on treatment discontinuation. Logistic regression was used to assess possible risk factors for CEs.

RESULTS

Individual patient-level data from 1961 patients exposed to T-DM1 in seven trials were pooled. Of these, 1544 received T-DM1 and 417 T-DM1 + pertuzumab. CHF/LVEF drop grade 3/4 was reported in 0.71%, cardiac ischemia in 0.1%, cardiac arrhythmia in 0.71% and grade 1/2 LVEF drop in 2.04%. The total CE rate was 3.37% (95% confidence interval (CI), 2.6%-4.3%). Multivariate analysis showed patient's age ≥65 (OR 3.0; 95% CI, 1.77-5.14; P-value <0.001) and baseline LVEF<55% (OR 2.62; 95% CI, 1.29-5.32; P-value 0.008) as risk factors. CEs resolved in most (79%) patients after treatment discontinuation.

CONCLUSION

The incidence of CEs in patients receiving T-DM1 was low. Older patients receiving T-DM1 should be carefully followed for cardiac safety during treatment.
Nguyen is offline   Reply With Quote
Reply

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is On

Forum Jump


All times are GMT -7. The time now is 12:52 AM.


Powered by vBulletin® Version 3.8.7
Copyright ©2000 - 2020, vBulletin Solutions, Inc.
Copyright HER2 Support Group 2007
free webpage hit counter