Retrospective analysis of cardiac tolerability of concurrent administration of trastuzumab and anthracycline-based regimen for breast cancer, to address one-year-term issues in LVEF

Article type: Research Article

Authors: Watanabe, Naoki^{a; *} | Otsuka, Shoko^a | Sasaki, Yoko^a | Yuasa, Takeshi^a | Shimada, Ken^b

Affiliations: [a] Department of Breast Surgery, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan | [b] Department of Pharmaceutics, Japanese Red Cross Society Himeji Hospital, Hyogo, Japan

Correspondence: [*] Corresponding author: Naoki Watanabe, Department of Breast Surgery, Japanese Red Cross Society Himeji Hospital, 1-12-1, Shimoteno, Himeji, Hyogo 670-8540, Japan. Tel.: +81 79 294 2251; Fax: +81 79 296 4050; E-mail:[email protected]

Abstract: BACKGROUND: Patients with HER2-positive breast cancer, who received paclitaxel (P) followed by epirubicin at 75 mg/m2, fluorouracil, and cyclophosphamide (FEC75) and concurrent trastuzumab (Trastuzumab Group) show good cardiac tolerability. We assessed left ventricular ejection fraction (LVEF) of these patients regularly, and compared with that of HER2-negative breast cancer patients who administered P followed by FEC100 (Standard Group), and followed for more one year, and address the longer-term issues in LVEF. OBJECTIVE & METHODS: We routinely assessed LVEF, at the time of initiation, after P, after FEC, and after 1 year, and compared them between 49 patients in Trastuzumab Group and 45 patients in Standard Group. RESULTS: In Trastuzumab Group, LVEF was reduced from the initial level (63.1%) to 60.4 at ``After FEC'' (p= 0.007), but had recovered to 60.9% at ``After 1 year''. A two-way repeated-measures ANOVA demonstrated a significant decline in LVEF level along the time course (p< 0.002), but there was no interaction revealed between time course of LVEF and treatment with or without trastuzumab (p= 0.834). In addition, there was no significant difference between groups (p= 0.386) CONCLUSIONS: P followed by FEC75 with concurrent trastuzumab could provide enough evidence of cardiac safety.

Keywords: Anthracyclines, trastuzumab, cardiotoxicity, adjuvant chemotherapy, breast cancer

DOI: 10.3233/BD-150418

Journal: Breast Disease, vol. 35, no. 4, pp. 253-261, 2015