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.
Volunteers in Sweden were tricked into thinking their bodies had vanished, and the "superpower" seemed to ease social fears
Scientists have for the first time captured how taste sensations are processed on the tongue
Researchers set hungry mosquitoes loose on identical and fraternal twins. They found that inherited genes do play a role in making you a mosquito magnet.
State education committee passes a bill banning parents exempting kids from vaccination because of "personal beliefs", as lawmakers around the world discuss similar measures
The torturous trial-and-error process of finding the best cancer drug for an individual could be a thing of the past thanks to a couple of clever devices
A flu strain deadly to chickens and turkeys is striking farms in the West and Midwest. This week, it hit an Iowa facility with millions of egg-laying hens. No one knows how it's entering houses.
Doctors, it turns out, often don't follow evidence-based guidelines. One result? Unnecessary tests. Scientists who study this contrariness think they know why.
Analysis of millions of audio files has led one US company to claim that their software can predict how a person’s voice will make a listener feel
Bird flu outbreak now spreading through Midwest poultry could head east with fall migration
A little MRI video seems to settle the decades-old debate about that loud pop of the joints: It's all about bubbles. But imagine an air bag inflating, not the bursting of a balloon.