Retrospective analysis of cardiac tolerability of concurrent administration of trastuzumab and anthracycline-based regimen for breast cancer, to address one-year-term issues in LVEF
Affiliations: [a] Department of Breast Surgery, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan | [b] Department of Pharmaceutics, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan
Correspondence:
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Corresponding author: Naoki Watanabe, Department of Breast Surgery, Japanese Red Cross Society Himeji Hospital, 1-12-1, Shimoteno, Himeji, Hyogo 670-8540, Japan. Tel.: +81 79 294 2251; Fax: +81 79 296 4050; E-mail:watanabe-naoki@hrc-hp.jp
Abstract:
BACKGROUND: Patients with HER2-positive breast cancer, who received
paclitaxel (P) followed by epirubicin at 75 mg/m2, fluorouracil, and
cyclophosphamide (FEC75) and concurrent trastuzumab (Trastuzumab Group) show
good cardiac tolerability. We assessed left ventricular ejection fraction
(LVEF) of these patients regularly, and compared with that of HER2-negative
breast cancer patients who administered P followed by FEC100 (Standard
Group), and followed for more one year, and address the longer-term issues
in LVEF. OBJECTIVE & METHODS: We routinely assessed LVEF, at the time of
initiation, after P, after FEC, and after 1 year, and compared them between
49 patients in Trastuzumab Group and 45 patients in Standard Group. RESULTS: In Trastuzumab Group, LVEF was reduced from the initial
level (63.1%) to 60.4 at ``After FEC'' (p= 0.007), but had recovered to
60.9% at ``After 1 year''. A two-way repeated-measures ANOVA demonstrated
a significant decline in LVEF level along the time course (p< 0.002), but
there was no interaction revealed between time course of LVEF and treatment
with or without trastuzumab (p= 0.834). In addition, there was no significant
difference between groups (p= 0.386) CONCLUSIONS: P followed by FEC75 with concurrent
trastuzumab could provide enough evidence of cardiac safety.
Keywords: Anthracyclines, trastuzumab, cardiotoxicity, adjuvant chemotherapy, breast cancer
DOI: 10.3233/BD-150418
Journal: Breast Disease, vol. 35, no. 4, pp. 253-261, 2015
