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- Title
Cardiotoxicity in breast cancer patients.
- Authors
Stănculeanu, Dana Lucia; Zob, Daniela; Toma, Oana; Mihăilă, Raluca
- Abstract
Background. Advances in early diagnosis and the development of treatments in breast cancer have led to improvements of disease-free and overall survival. Chemotherapy and targeted therapies induced cardiotoxicity is concerning, and the cardiovascular side effects can impact the quality of life and survival. Cardiac risk factors should be assessed when deciding on treatment regimens for breast cancer. Methods. The study aims to determine risk factors favoring cardiac-induced toxicity of trastuzumab in patients treated at the “Prof. Dr. Al. Trestioreanu” Institute of Oncology Bucharest within four years, from 2010 to 2013. The study included 368 patients diagnosed with breast cancer, HER2/neu-positive with neoadjuvant/adjuvant chemotherapy and adjuvant trastuzumab. The primary study objective is to determine the incidence of cardiotoxicity and the impact of risk factors among patients with breast cancer, HER2/neu-positive, treated with trastuzumab and anthracycline compared to literature. The second objective is establishing the proportion of patients who experienced reversible cardiotoxicity and clinical manifestations related cardiotoxicity, following treatment with trastuzumab and anthracyclines. Results. The analysis showed that adjuvant treatment was indicated in 257 patients and that 111 patients had metastatic disease, of which 44 patients were treated with trastuzumab in adjuvant setting and 67 were naive to treatment with trastuzumab. Patients receveing trastuzumab had the following risk factors for cardiotoxicity: increased body mass index, smoking, sedentary, high cholesterol, high blood pressure, diabetes. Reversible cardiotoxicity was noticed in 16% of the cases (from the total of 368 patients) and required the temporary interruption of the administration of trastuzumab, and one patient with trastuzumab developed irreversible cardiotoxicity. 16 patients had symptomatic heart failure. The study results showed that administering trastuzumab to women with these cardiovascular risk factors led to increased cardiotoxicity and the reduction of LVEF, requiring temporary interruption of trastuzumab. Conclusions. Early recognition of cardiac toxicity can lead to improvement in cardiac survival and patient outcomes. The focus of this review was to summarize the cancer therapy agents most often associated with cardiovascular side effects, highlighting the risk factors that can be improved and strategies for surveillance and prevention. The incidence of cardiotoxicity and the impact of risk factors among patients with breast cancer, HER2/neu-positive, treated with trastuzumab and anthracycline, are similar to those presented in data from literature. Early identification of individuals at risk and monitoring patients during chemotherapy are very important, and they can facilitate early intervention with cardioprotective medications or adjustments to the chemotherapy regimen.
- Subjects
BREAST cancer patients; CARDIOTOXICITY; CHEMOTHERAPY complications
- Publication
Oncolog-Hematolog, 2016, Issue 37, p25
- ISSN
2066-8716
- Publication type
Article