Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience

Introduction: Trastuzumab, a recombinant humanized monoclonal antibody, targets the external domain of HER2 to improve the efficacy of HER2-positive breast cancer treatment and inhibit carcinoma cellular proliferation. The purpose of this study was to identify early changes in cardiac function and d...

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Main Authors: Che-Ming Chang, Fiona Tsui-Fen Cheng, Tsen-Long Yang, Wu-Chin Wen
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2015-06-01
Series:Journal of Cancer Research and Practice
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2311300616300702
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author Che-Ming Chang
Fiona Tsui-Fen Cheng
Tsen-Long Yang
Wu-Chin Wen
author_facet Che-Ming Chang
Fiona Tsui-Fen Cheng
Tsen-Long Yang
Wu-Chin Wen
author_sort Che-Ming Chang
collection DOAJ
description Introduction: Trastuzumab, a recombinant humanized monoclonal antibody, targets the external domain of HER2 to improve the efficacy of HER2-positive breast cancer treatment and inhibit carcinoma cellular proliferation. The purpose of this study was to identify early changes in cardiac function and dimensional changes in heart size in patients treated with trastuzumab. Materials and Methods: Seventy three female patients with Her2/neu overexpression (IHC 3+/Fish +) in breast cancer underwent echocardiography before and after trastuzumab therapy. Results: Cardiac complications developed in 14 patients (19.2%), including asymptomatic left ventricle systolic dysfunction (n = 12), symptomatic heart failure (n = 2), new asymptomatic left bundle branch block (n = 1), new negative T waves on electrocardiogram (n = 2), pericardial effusion (n = 1), and death (n = 1). No significant deterioration in diastolic function was noted, and right heart diameters and function did not change significantly. Most patients remained in an asymptomatic stage of cardiac disease. A significant decrease in left ventricular ejection fraction (LVEF) was observed in 14 patients (19.2%), and new mitral regurgitation (≥ grade 1) was noted after 3 months of trastuzumab therapy in 7 patients (9.6%). Conclusions: Trastuzumab led to measurable decreases in LVEF (but only 2.7% was symptomatic heart failure) and new mitral regurgitation. Therefore, regular follow-up with echocardiography is essential for early detection and prevention of trastuzumab-induced cardiomyopathy.
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spelling doaj.art-81712c4db04343d5979c8d73fa6a2d7a2022-12-22T01:43:54ZengWolters Kluwer Medknow PublicationsJournal of Cancer Research and Practice2311-30062015-06-012213915010.6323/JCRP.2015.2.2.05Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year ExperienceChe-Ming Chang0Fiona Tsui-Fen Cheng1Tsen-Long Yang2Wu-Chin Wen3Division of Cardiology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDivision of General Surgery, Department of Surgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDivision of General Surgery, Department of Surgery, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, TaiwanIntroduction: Trastuzumab, a recombinant humanized monoclonal antibody, targets the external domain of HER2 to improve the efficacy of HER2-positive breast cancer treatment and inhibit carcinoma cellular proliferation. The purpose of this study was to identify early changes in cardiac function and dimensional changes in heart size in patients treated with trastuzumab. Materials and Methods: Seventy three female patients with Her2/neu overexpression (IHC 3+/Fish +) in breast cancer underwent echocardiography before and after trastuzumab therapy. Results: Cardiac complications developed in 14 patients (19.2%), including asymptomatic left ventricle systolic dysfunction (n = 12), symptomatic heart failure (n = 2), new asymptomatic left bundle branch block (n = 1), new negative T waves on electrocardiogram (n = 2), pericardial effusion (n = 1), and death (n = 1). No significant deterioration in diastolic function was noted, and right heart diameters and function did not change significantly. Most patients remained in an asymptomatic stage of cardiac disease. A significant decrease in left ventricular ejection fraction (LVEF) was observed in 14 patients (19.2%), and new mitral regurgitation (≥ grade 1) was noted after 3 months of trastuzumab therapy in 7 patients (9.6%). Conclusions: Trastuzumab led to measurable decreases in LVEF (but only 2.7% was symptomatic heart failure) and new mitral regurgitation. Therefore, regular follow-up with echocardiography is essential for early detection and prevention of trastuzumab-induced cardiomyopathy.http://www.sciencedirect.com/science/article/pii/S2311300616300702trastuzumabcardiotoxicitybreast cancerHER2 over expression
spellingShingle Che-Ming Chang
Fiona Tsui-Fen Cheng
Tsen-Long Yang
Wu-Chin Wen
Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
Journal of Cancer Research and Practice
trastuzumab
cardiotoxicity
breast cancer
HER2 over expression
title Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
title_full Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
title_fullStr Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
title_full_unstemmed Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
title_short Cardiotoxicity Associated with Trastuzumab Therapy in Taiwan: A Single Medical Center's 5-Year Experience
title_sort cardiotoxicity associated with trastuzumab therapy in taiwan a single medical center s 5 year experience
topic trastuzumab
cardiotoxicity
breast cancer
HER2 over expression
url http://www.sciencedirect.com/science/article/pii/S2311300616300702
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AT tsenlongyang cardiotoxicityassociatedwithtrastuzumabtherapyintaiwanasinglemedicalcenters5yearexperience
AT wuchinwen cardiotoxicityassociatedwithtrastuzumabtherapyintaiwanasinglemedicalcenters5yearexperience