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.
UN assistant secretary general says deadly outbreak, which has been blamed on UN troops, demands decisive action
Caffeine is the drug many of us can't live without – but do you have any idea how much is in your daily hit?
Warmer temperatures are causing malaria to spread in the African and South American highlands, traditionally havens from the disease, scientists say.
How best to achieve success is a highly contentious issue, but politicians should remember that a good start in life is key
A second child seems to have been cleared of the AIDS virus, thanks to heavy-duty drugs started just hours after birth. This spring researchers plan to test that approach in 60 more newborns.
A report finds that azodicarbonamide wasn't just in Subway's bread: It's in hundreds of foods. While it has been linked to asthma in factory workers, the additive poses no known risk to consumers.
Army initiative to research suicides in the US military released its first three studiesAmanda Holpuch
The luxury fibre can be fashioned into screws and plates that could hold broken bones together while they heal, before biodegrading when no longer needed
Middle-aged people on a high-protein diet are at greater risk of dying from cancer, claims a study, but critics say firm evidence is lacking
In an exclusive interview with National Geographic, Nora Volkow, director of the National Institute on Drug Abuse, shares her concerns about the consequences of legalizing the drug.