Navigation Links
Trastuzumab raises risk of heart problems in the elderly with history of heart disease or diabetes
Date:8/9/2011

221.10.254.64

The first study to investigate the effect of the breast cancer drug trastuzumab (Herceptin) on heart and vascular function in elderly patients has found that it increases the risk of heart problems, particularly in women with a history of heart disease, diabetes or both.

Authors of the study, published in the cancer journal, Annals of Oncology today [1], looked at records for 45 women aged between 70 and 92 who had been treated with trastuzumab since 2005 and found that 26.7% (12) of the patients developed heart problems caused by the drug a slightly higher rate than seen in earlier, clinical trials in younger, healthier women. Thirty-three percent of the women with a history of heart disease developed either asymptomatic and symptomatic heart problems as a result of taking trastuzumab, compared to only 9.1% of women without such a history, and 33.3% of women with diabetes developed problems compared to only 6.1% without the condition. When trastuzumab treatment was stopped, all but one of the women recovered fully and five of them were able to re-start the treatment.

Trastuzumab is the current standard of care for women diagnosed with the type of breast cancer that expresses the protein HER2 on the surface of the cancer cells (HER2 positive breast cancer). Although breast cancer is most common in elderly women, clinical trials of trastuzumab have been carried out in younger women, "ideal patients", who have few if any other health-related issues.

Dr Csar Serrano, who carried out the research while working as a clinical fellow at the Department of Medical Oncology Breast Cancer Centre at the Vall d'Hebron University Hospital in Barcelona, Spain, said: "This is the first study specifically to assess trastuzumab-related cardiac toxicity and the cardiovascular factors that are associated with an increased risk in a selected population of elderly breast cancer patients.

"Trastuzumab is generally well-tolerated and, although there are some concerns about it causing heart problems, until now few risk factors have been identified among patients in clinical trials, most of whom are usually younger than 70 years and have good general health. Our study has demonstrated a significantly increased incidence of cardiac events among patients aged 70 and over with cardiovascular risk factors such as a history of cardiac disease and diabetes.

"Approximately 70% of all newly diagnosed cancers occur in patients older than 65 and, given the expected increase in the absolute number of elderly cancer patients over the coming decades in Western countries, there is an unmet need for information about the efficacy and safety of anti-cancer treatments in daily clinical practice. Data obtained in this report can serve to advise clinicians to be aware of symptomatic and asymptomatic cardiac dysfunction in elderly patients. We think that it is reasonable to refer elderly breast cancer patients to a cardiologist if one or more cardiovascular risk factors are present before or during treatment with trastuzumab. Moreover, a closer surveillance of early symptoms and cardiac function is highly recommended."

Asymptomatic cardiotoxicity is defined as when there are no obvious symptoms of any heart problems, but assessment (usually via scanning or echocardiography) of the function of the heart's left ventricle shows an absolute drop of 10% or more, resulting in a left ventricle ejection fraction (LVEF) of less than 50% of normal its normal function, or an absolute drop of more than 20%. Symptomatic cardiotoxicity, such as congestive heart failure, has obvious physical symptoms such as shortness of breath and swelling limbs.

Out of the 12 patients who developed heart problems, eight developed asymptomatic LVEF decline and four developed symptomatic congestive heart failure. All eight, asymptomatic patients recovered completely after they stopped taking trastuzumab, and then the drug was reintroduced in four patients. Only one of these had a repeat asymptomatic drop in LVEF, which improved without withdrawing the treatment.

"One of the main characteristics of trastuzumab cardiotoxicity is its reversibility. It is a well-known phenomenon that differs from other chemotherapeutic agents such as anthracyclines. Reversibility normally happens with treatment discontinuation, but also can also occur spontaneously," explained Dr Serrano. "The decision to reintroduce trastuzumab, or to continue with it, must be taken case-by-case together with a cardiologist."

Of the four patients who developed symptomatic congestive heart failure, three recovered their cardiac function after discontinuing trastuzumab and receiving standard cardiac therapy, and one was able to restart trastuzumab without any further problems. The fourth woman did not recover cardiac function, showing only a slight improvement and the doctors did not reintroduce any cancer treatment because of this. She died three months later due to progression of her cancer.

Dr Serrano, who is now working as a postdoctoral research fellow at the Brigham and Women's Hospital in Boston, USA, concluded: "It's important to be cautious when interpreting our data given the small number of women involved in the study and the very limited power to detect small differences. However, until safety cardiac data in elderly patients receiving trastuzumab becomes available from prospective clinical trials, this study may contribute to identifying those elderly women with breast cancer who are most likely to develop heart problems during treatment with trastuzumab."


'/>"/>

Contact: Emma Mason
wordmason@mac.com
European Society for Medical Oncology
Source:Eurekalert

Related medicine news :

1. Smoking After Heart Attack Raises Risk of Dying
2. Localized reactive badger culling raises bovine tuberculosis risk, new analysis confirms
3. Too Much TV Raises Risk of Diabetes, Heart Disease and Death
4. Good Sleep Raises Quality of Life, Lowers Depression
5. Obesity raises breast cancer survivors risk of dying of the cancer
6. Smoking Raises Odds for Cancer in Women Already at High Risk
7. Rise of for-profit hospice industry raises troubling questions, new study says
8. Hospital Infection Raises Death Risk for Bowel Patients
9. NIDA raises the curtain on addiction
10. Large weight gain raises risk for recurrence among breast cancer survivors
11. Nicotine Raises Blood Sugar Levels in Lab
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/27/2016)... ... , ... TopConsumerReviews.com recently awarded their highest five-star rating to Best Buy Eyeglasses, ... the United States and Canada wear eyeglasses. Once considered to be a purely functional ... a fashion statement. Even celebrities use glasses as a way of creating an iconic ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified ... be personalized through a fitness app. The fitness app plans to fix the two major ... only offer a one size fits all type program , They don’t eliminate ...
(Date:6/25/2016)... ... ... "With 30 hand-drawn hand gesture animations, FCPX users can easily customize each ... Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures into hand ... select a ProHand generator and drag it above media or text in the Final ...
(Date:6/25/2016)... ... June 25, 2016 , ... Conventional wisdom preaches the benefits ... terms of the latter, setting the bar too high can result in disappointment, perhaps ... slow progress toward their goal. , Research from PsychTests.com reveals that ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary Hypertension Association ... it will receive two significant new grants to support its work to advance ... 25th anniversary by recognizing patients, medical professionals and scientists for their work in ...
Breaking Medicine News(10 mins):
(Date:6/26/2016)... , June 27, 2016  VMS Rehab Systems, ... Board will take whatever measures required to build a ... stock which is currently listed on the OTC Markets-pink ... Company Chairman and CEO, "We are seeing an anomaly ... to understand, not only by the Company, but shareholders ...
(Date:6/24/2016)... FRANCISCO, Calif. , June 24, 2016 /PRNewswire/ ... ), a biopharmaceutical company developing novel therapeutics for ... unmet needs, today announced the closing of its ... of common stock, at the public offering price ... in the offering were offered by GBT. GBT ...
(Date:6/24/2016)... 24, 2016 The Academy of Managed Care ... that would allow biopharmaceutical companies to more easily ... make formulary and coverage decisions, a move that addresses ... medicines. The recommendations address restrictions in the ... the drug label, a prohibition that hinders decision makers ...
Breaking Medicine Technology: