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In Breast CA, Cardiotoxicity Up With Trastuzumab-Based Chemo

Increased risk of cardiotoxicity for trastuzumab with nonanthracycline chemo, sequential tx

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WEDNESDAY, April 20, 2016 (HealthDay News) -- For adult women with breast cancer, trastuzumab-based regimens are associated with increased risk of cardiotoxicity, according to a study published online April 18 in the Journal of Clinical Oncology.

In an effort to examine the risk of cardiotoxicity with breast cancer therapy, Paaladinesh Thavendiranathan, M.D., from Toronto General Hospital, and colleagues conducted a population-based retrospective cohort study involving 14 regional cancer centers. A total of 18,540 adult women (median age, 54 years) receiving chemotherapy for stage I to III breast cancer between 2007 and 2012 were included.

The researchers found that the primary outcome (a composite of hospitalization or emergency room visit for congestive heart failure [CHF], outpatient diagnosis of CHF, or cardiovascular death) had a cumulative incidence of 3.08 percent by three years of follow-up, compared with 0.96 percent in an age-matched sample of 92,700 Ontario women without breast cancer. Patients receiving trastuzumab with nonanthracycline chemotherapy and sequential therapy had increased risk of cardiotoxicity compared with those receiving other chemotherapy (hazard ratios, 1.76 and 3.96, respectively). With sequential therapy only, hospital-based CHF events were increased (hazard ratio, 1.86).

"In women with breast cancer and an age distribution representative of routine clinical practice, trastuzumab-based regimens, including those without anthracyclines, were associated with an increased risk of cardiotoxicity," the authors write.

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