Ghent University Academic Bibliography

Advanced

Cardiac toxicity of trastuzumab: experience at the Ghent University Hospital, Belgium

CAROLINE LAMOT UGent, Sylvie Rottey UGent, Tine De Backer UGent, Lucas Van Bortel, Hugo Robays UGent, Simon Van Belle UGent, Hannelore Denys UGent and Veronique Cocquyt UGent (2010) ACTA CLINICA BELGICA. 65(5). p.300-304
abstract
Introduction Trastuzumab (TRAS) is a humanised monoclonal antibody that is targeted against the HER2 growth factor receptor. Over-expression of the receptor occurs in around 15-25% of women with early breast cancer (CA). Four major adjuvant trials compared trastuzumab treatment with observation after neoadjuvant or adjuvant chemotherapy in women with high risk HER2-positive breast cancer. Results of these trials showed that trastuzumab treatment given every 3 weeks for 1 year achieved a significant improvement of disease free survival and overall survival However, cardiac toxicity occurred more in the trastuzumab arm than in the observation arm resulting in symptomatic congestive heart failure and a significant drop in left ventricular ejection function (LVEF). Aim of the study The purpose of this analysis is to evaluate cardiac toxicity of adjuvant trastuzumab treatment in 30 breast cancer patients. Study parameters were cardiac toxicity assessed by LV function, disease free survival and overall survival. Materials and methods Based on the adjuvant trials and in expectation of the reimbursement of trastuzumab in the adjuvant setting, a convention was set up between the Belgian National Institute for Health and Disability Insurance and hospital centres specialized in the treatment of breast cancer. In this convention, trastuzumab was offered to patients diagnosed with invasive, non-metastatic breast cancer with an over-expression of HER2 proven by a positive FISH test. Metastatic lymph nodes or a tumour measuring more than 10 mm had to be present. At least 4 cycles of adjuvant or neoadjuvant chemotherapy had to be given to the patient. Radiotherapy could be administered. The time interval between chemotherapy or radiotherapy and treatment with trastuzumab could not be more than 6 months LVEF determined by MUGA scan or by ultrasonography at the start of trastuzumab treatment had to be more than 55%. Results 30 breast cancer patients were treated with adjuvant trastuzumab in our hospital between June 2006 and July 2007 All patients met the inclusion criteria. Six patients stopped trastuzumab treatment because of cardiac toxicity. All these patients had received prior anthracycline neoadjuvant or adjuvant chemotherapy Five of these patients were found to have a LVEF < 55%, one showing symptoms of congestive cardiomyopathy. The sixth patient was diagnosed with a newly developed tricuspid valve insufficiency grade 3. Follow-up data of 20 months since the start of trastuzumab treatment showed that 27 patients were disease-free Two patients died because of progressive breast cancer disease. One patient was lost of follow-up. Conclusion In this small group of breast cancer patients, treated with adjuvant trastuzumab, cardiac toxicity expressed as a decreased left ventricular function seems to have a higher incidence compared to the other adjuvant trials. Therefore, a close cardiac monitoring for several years should be recommended in patients treated with trastuzumab
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
breast cancer, trastuzumab, left ventricular function, cardiac toxicity, CANCER
journal title
ACTA CLINICA BELGICA
Acta Clin. Belg.
volume
65
issue
5
pages
300 - 304
Web of Science type
Article
Web of Science id
000283674000002
JCR category
MEDICINE, GENERAL & INTERNAL
JCR impact factor
0.532 (2010)
JCR rank
104/151 (2010)
JCR quartile
3 (2010)
ISSN
0001-5512
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1084902
handle
http://hdl.handle.net/1854/LU-1084902
date created
2010-12-08 14:20:48
date last changed
2016-12-19 15:44:33
@article{1084902,
  abstract     = {Introduction Trastuzumab (TRAS) is a humanised monoclonal antibody that is targeted against the HER2 growth factor receptor. Over-expression of the receptor occurs in around 15-25\% of women with early breast cancer (CA). Four major adjuvant trials compared trastuzumab treatment with observation after neoadjuvant or adjuvant chemotherapy in women with high risk HER2-positive breast cancer. Results of these trials showed that trastuzumab treatment given every 3 weeks for 1 year achieved a significant improvement of disease free survival and overall survival However, cardiac toxicity occurred more in the trastuzumab arm than in the observation arm resulting in symptomatic congestive heart failure and a significant drop in left ventricular ejection function (LVEF).
Aim of the study The purpose of this analysis is to evaluate cardiac toxicity of adjuvant trastuzumab treatment in 30 breast cancer patients. Study parameters were cardiac toxicity assessed by LV function, disease free survival and overall survival.
Materials and methods Based on the adjuvant trials and in expectation of the reimbursement of trastuzumab in the adjuvant setting, a convention was set up between the Belgian National Institute for Health and Disability Insurance and hospital centres specialized in the treatment of breast cancer. In this convention, trastuzumab was offered to patients diagnosed with invasive, non-metastatic breast cancer with an over-expression of HER2 proven by a positive FISH test. Metastatic lymph nodes or a tumour measuring more than 10 mm had to be present. At least 4 cycles of adjuvant or neoadjuvant chemotherapy had to be given to the patient. Radiotherapy could be administered. The time interval between chemotherapy or radiotherapy and treatment with trastuzumab could not be more than 6 months LVEF determined by MUGA scan or by ultrasonography at the start of trastuzumab treatment had to be more than 55\%.
Results 30 breast cancer patients were treated with adjuvant trastuzumab in our hospital between June 2006 and July 2007 All patients met the inclusion criteria. Six patients stopped trastuzumab treatment because of cardiac toxicity. All these patients had received prior anthracycline neoadjuvant or adjuvant chemotherapy Five of these patients were found to have a LVEF {\textlangle} 55\%, one showing symptoms of congestive cardiomyopathy. The sixth patient was diagnosed with a newly developed tricuspid valve insufficiency grade 3.
Follow-up data of 20 months since the start of trastuzumab treatment showed that 27 patients were disease-free Two patients died because of progressive breast cancer disease. One patient was lost of follow-up.
Conclusion In this small group of breast cancer patients, treated with adjuvant trastuzumab, cardiac toxicity expressed as a decreased left ventricular function seems to have a higher incidence compared to the other adjuvant trials. Therefore, a close cardiac monitoring for several years should be recommended in patients treated with trastuzumab},
  author       = {LAMOT, CAROLINE and Rottey, Sylvie and De Backer, Tine and Van Bortel, Lucas and Robays, Hugo and Van Belle, Simon and Denys, Hannelore and Cocquyt, Veronique},
  issn         = {0001-5512},
  journal      = {ACTA CLINICA BELGICA},
  keyword      = {breast cancer,trastuzumab,left ventricular function,cardiac toxicity,CANCER},
  language     = {eng},
  number       = {5},
  pages        = {300--304},
  title        = {Cardiac toxicity of trastuzumab: experience at the Ghent University Hospital, Belgium},
  volume       = {65},
  year         = {2010},
}

Chicago
LAMOT, CAROLINE, Sylvie Rottey, Tine De Backer, Lucas Van Bortel, Hugo Robays, Simon Van Belle, Hannelore Denys, and Veronique Cocquyt. 2010. “Cardiac Toxicity of Trastuzumab: Experience at the Ghent University Hospital, Belgium.” Acta Clinica Belgica 65 (5): 300–304.
APA
LAMOT, CAROLINE, Rottey, S., De Backer, T., Van Bortel, L., Robays, H., Van Belle, S., Denys, H., et al. (2010). Cardiac toxicity of trastuzumab: experience at the Ghent University Hospital, Belgium. ACTA CLINICA BELGICA, 65(5), 300–304.
Vancouver
1.
LAMOT C, Rottey S, De Backer T, Van Bortel L, Robays H, Van Belle S, et al. Cardiac toxicity of trastuzumab: experience at the Ghent University Hospital, Belgium. ACTA CLINICA BELGICA. 2010;65(5):300–4.
MLA
LAMOT, CAROLINE, Sylvie Rottey, Tine De Backer, et al. “Cardiac Toxicity of Trastuzumab: Experience at the Ghent University Hospital, Belgium.” ACTA CLINICA BELGICA 65.5 (2010): 300–304. Print.