Heart failure is a relatively common complication in older women with breast cancer, but the risk is even higher in those patients treated with adjuvant trastuzumab (Herceptin©), Yale School of Medicine researchers report in the current issue of the Journal of the American College of Cardiology.
The researchers conducted this study because older women who are at higher risk of decreased heart function, were often excluded from randomized clinical trials of trastuzumab, which is used to treat breast tumors that over-express human epidermal growth factor receptor-2 (HER-2). Past clinical trials in younger, healthier women showed improved survival, but also increased heart complications linked to trastuzumab, especially when combined with a frequently used therapy called anthracycline chemotherapy.
"We observed an even higher risk of heart failure or cardiomyopathy after trastuzumab therapy than those in past clinical trials," said lead author Jersey Chen, M.D., assistant professor of cardiology at Yale University School of Medicine and a member of the Yale Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale.
The Yale COPPER team examined the association between the use of adjuvant trastuzumab and anthracycline therapy and heart failure and cardiomyopathy, the most serious cardiotoxic complications, in 45,536 female Medicare beneficiaries with early-stage breast cancer. The use of trastuzumab has increased over time from 2.6% of the women who received any adjuvant therapy in 2000 to 22.6% in 2007.
The team found that compared with patients who received no adjuvant chemotherapy or trastuzumab; use of trastuzumab was associated with a 14% higher adjusted incidence rate for heart failure or cardiomyopathy over three years. Patients who received both trastuzumab and anthracycline had a 23.8% higher rate, and those treated with anthracycline chemotherapy alone had a 2.1% higher rate of heart failure or cardiomyopathy events over three years.
"Further study is needed to fully understand the benefits and risks of trastuzamab when they are used in the real-world population," said Cary Gross, senior author of the study and director of the COPPER Center.
Yale University: http://www.yale.edu
This press release was posted to serve as a topic for discussion. Please comment below. We try our best to only post press releases that are associated with peer reviewed scientific literature. Critical discussions of the research are appreciated. If you need help finding a link to the original article, please contact us on twitter or via e-mail.
Doctors have used perfect replicas of childrens' hearts to uncover and repair hidden defects
An experiment testing people’s altruism in the face of electric shocks is clear on one thing: we are drawn to these little blasts
Researchers gear up tests in West Africa to see whether blood from Ebola survivors can help people who are sick with the disease. This is part of a broader effort to test therapies in West Africa.
The virus's foray into Europe coincides with peak production of Christmas turkeys, the poultry species most vulnerable to bird flu
A novel kind of nanoparticle could lead to more effective cancer treatments.Patients and doctors often don’t know if surgery to remove cancerous tissue was successful until scans are performed months later. A new kind of nanoparticle could show patients if they’re in the clear much earlier.
One challenge in evaluating the effectiveness of different medical procedures, is that patients behave differently after different procedures. Is this true for patients getting heart surgery?
It is only in the aftermath of treatment that survivors discern that their adrenalin alone wont fuel the rest of their recovery. For many, surviving cancer is followed by even more hardship
Just down the road from Facebook and Google, Dr. Phil Wagner runs a laboratory dedicated to optimizing the performance of some of the world's top athletes. At Sparta Performance Science in Menlo Park, California, Wagner and his team bring the spirit of Silicon Valley to bear on the athletic world, helping athletes find the tiny advantages that add to championships. Join us for a trip inside the lab to see where sports meets science.
Pieter Cohen, an internist in Massachusetts, got interested in dietary supplements several years ago, when some of his …
The risk of overdiagnosis and false positives means the UK may be barking up the wrong tree in trialling a wider target age range for breast screening