News | Cardiac Diagnostics | April 28, 2016

Heart Monitoring Suggested for All Breast Cancer Patients Undergoing Herceptin Treatment

Canadian study finds patients of all ages at higher risk of heart damage as side effect of chemotherapy drug

breast cancer, herceptin chemotherapy drug, heart damage, monitoring, Journal of Clinical Oncology study

April 28, 2016 — Breast cancer patients undergoing treatment with trastuzumab-containing regimens should be monitored for heart damage regardless of age. This is among the findings of a new study from the Peter Munk Cardiac Centre, the Institute for Clinical Evaluative Sciences (ICES) and the Ted Rogers Centre for Heart Research, University Health Network (UHN). The study was published April 18 in the Journal of Clinical Oncology.

Trastuzumab-containing regimens (commonly marketed as Herceptin) for breast cancer have significantly improved survival for breast cancer patients. However, this treatment is known to carry a risk of congestive heart failure, which is particularly of concern when used along with anthracyclines (another class of drugs). Accordingly, treatment guidelines generally advise careful monitoring of older patients who are assumed to be at higher risk of heart events. To date there has not been strong clinical evidence for whether or not younger patients should be equally monitored for heart damage.

“Breast cancer is the most common type of cancer in Canadian women and treatments for early-stage breast cancer have proven highly effective,” said the study’s lead author Dinesh Thavendiranathan, M.D., who is a cardiologist at the Peter Munk Cardiac Centre and the director of the Ted Rogers Program in Cardiotoxicity Prevention, Ted Rogers Centre for Heart Research. “Unfortunately, some of the drugs used for the treatment of breast cancer are associated with injury to the heart and heart dysfunction. If you look at the clinical trials which were used to approve these drugs, the risk of heart dysfunction was not very high. But when these drugs are used in clinical practice, they’re used on a broader cohort of patients and some of these patients had a higher risk of heart dysfunction.”

The researchers looked at anonymized health records stored and analyzed at the Institute for Clinical Evaluative Sciences. They looked at treatments and outcomes for 18,540 Ontario women diagnosed with breast cancer between 2007 and 2012. The median age was 54, and 79 percent of the patients were younger than 65.

The study found that the adjusted rate of major cardiac events was 6.6 percent with sequential therapy (anthracyclines followed by trastuzumab), nearly four times higher than the reference group of patients receiving other chemotherapy. They found that patients receiving trastuzumab without anthracyclines had a 5.1 percent incidence of major cardiac events, which is 1.76 times higher than the reference group. Patients receiving anthracyclines without trastuzumab were not at a higher risk.

The authors say this study is larger than previous studies, with the number of patients receiving trastuzumab or sequential therapy approximately twice as large as the previous largest population-based study. Additionally, the inclusion of patients under the age of 65 allowed for new data that shows cumulative incidence estimates between younger and older patients, as well as incidence comparisons with a large age matched cohort without breast cancer.

“Trastuzumab regimens for breast cancer have greatly improved survival of breast cancer patients,” said Douglas Lee, M.D., Ph.D., also an author on the paper and a senior core scientist in the Cardiovascular Research Program at the Institute for Clinical Evaluative Sciences. “Although the absolute risk was higher in older patients, younger patients were also at significant risk of major cardiac events with cancer treatment regimens. These results suggest the need for equal consideration of surveillance for breast cancer therapy-related cardiac dysfunction in younger patients who have until now been considered at lower risk for cardiotoxicity from these drugs.”

For more information: www.jco.ascopubs.org

Related Content

News | Cardiac Diagnostics | June 14, 2018
A team of researchers says it has linked sensitivity to an allergen in red meat to the buildup of plaque in the...
The blood of patients with familial chylomicronemia syndrome (FCS) can appear milky in color (lipemic) due to the buildup of fat in their body. Image courtesy of Akcea Therapeutics.

The blood of patients with familial chylomicronemia syndrome (FCS) can appear milky in color (lipemic) due to the buildup of fat in their body. Image courtesy of Akcea Therapeutics.

 

Feature | Cardiac Diagnostics | May 07, 2018 | Steven D. Freedman, M.D., Ph.D.
 
Male Triathletes May Be Putting Their Heart Health at Risk
News | Cardiac Diagnostics | January 09, 2018
Competitive male triathletes face a higher risk of a potentially harmful heart condition called myocardial fibrosis,...
ERT Acquires iCardiac Technologies
News | Cardiac Diagnostics | December 19, 2017
ERT recently announced it has acquired iCardiac Technologies, a provider of centralized cardiac safety and respiratory...
New Study Suggests Protein Could Protect Against Coronary Artery Disease

Patients with no obstructed blood flow in the coronary arteries had higher levels of CXCL5 (blue) compared to patients with moderate levels (green) or lower levels (yellow) of CXCL5, who had increased severity of coronary obstructions (indicated by the arrows). Credit: Schisler lab

News | Cardiac Diagnostics | December 07, 2017
December 7, 2017 — The buildup of plaque in the heart’s arteries is an unfortunate part of aging.
E-cigarettes Most Likely to be Used by Alcohol Drinkers and Former Cigarette Smokers, at American Heart Association (AHA), #AHA2017.
News | Cardiac Diagnostics | December 06, 2017
December 6, 2017 — Electronic cigarettes are more frequently used by people who recently quit smoking and alcohol dri
Lack of sleep may cause heart disease in older women. American heart Association, #AHA2017
News | Cardiac Diagnostics | December 06, 2017
December 6, 2017 — Older women who do not get enough sleep were more likely to have poor cardiovascular health, accor
New Tool Predicts Risk of Heart Attack in Older Surgery Patients
News | Cardiac Diagnostics | December 05, 2017
A tool designed to more accurately predict the risk of heart attack in older patients undergoing non-cardiac surgery...
Overlay Init