Risk Profiling of Cancer Treatment-Related Cardiovascular Disorders in Breast Cancer Patients Who Received Adjuvant Chemotherapy With Trastuzumab

• Shinano Hiromi

  Clinical Pharmacology and Regulatory Science, Graduate School of Medicine, Juntendo University

• Miyazaki Sakiko

  Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University

• Miura Kayo

  Department of Breast and Endocrine Surgery, Graduate School of Medicine, Juntendo University

• Ohtsu Hiroshi

  Leading Center for the Development and Research of Cancer Medicine, Juntendo University Center for Clinical Sciences, Department of Data Science, National Center for Global Health and Medicine Institute for Medical Regulatory Science, Organization for University Research Initiatives, Waseda University

• Yonemoto Naohiro

  Innovative Medical Technology Research & Development Center, Juntendo University Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry

• Matsuoka Kiyoshi

  Innovative Medical Technology Research & Development Center, Juntendo University Center for Clinical Sciences, Department of Data Science, National Center for Global Health and Medicine

• Konishi Hakuou

  Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University

• Daida Hiroyuki

  Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University Innovative Medical Technology Research & Development Center, Juntendo University

• Saito Mitsue

  Department of Breast and Endocrine Surgery, Graduate School of Medicine, Juntendo University

• Sase Kazuhiro

  Clinical Pharmacology and Regulatory Science, Graduate School of Medicine, Juntendo University Institute for Medical Regulatory Science, Organization for University Research Initiatives, Waseda University

抄録

Background:The prognosis of cancer survivors has dramatically improved, but effective strategies for cancer treatment-related cardiovascular disorders (CTRCD) remain to be elucidated in the emerging field of cardio-oncology. In this study, we investigated risk factors for CTRCD in breast cancer patients treated with trastuzumab. Methods and Results:We performed a retrospective analysis of 141 consecutive women who received adjuvant trastuzumab, and underwent baseline (BL) and follow-up (FU) echocardiography at Juntendo University between April 2010 and December 2016. The major concomitant treatment was anthracyclines in 94% and radiotherapy in 53%. During the median treatment period of 11 months, there were 22 (15.6%) cardiology consultations, 3 (2.1%) treatment interruptions with irreversible CTRCD, and no deaths. Left ventricular ejection fraction (LVEF) was decreased from a median 67.5% (BL) to 63.4% (FU; P<0.0001), with reduced LVEF noted in 26.2% at FU<90%BL, in 13.5% at FU<BL–10%, and in 5.7% at LVEF_FU<53%. A significantly greater percentage of patients with CTRCD (FU<BL–10% and LVEF_FU<53%) had cardiovascular risk factors (CVRF; 42.9% vs. 8.2%, P=0.02). On multivariable analysis, CVRF were also significantly associated with CTRCD (OR, 11.96; 95% CI: 1.30–110.34). Conclusions:Adjuvant trastuzumab for early-stage breast cancer was associated with reduced LVEF; and CVRF were an independent predictor for CTRCD. The concomitant effect of anthracyclines should not be underestimated, even at lower doses.

収録刊行物

• Circulation Reports

  Circulation Reports 2 (4), 235-242, 2020-04-10

  一般社団法人 日本循環器学会

キーワード

• Breast cancer
• Cancer treatment-related cardiovascular disorder
• Cardio-oncology
• Cardiovascular risk factor
• Trastuzumab

詳細情報

• CRID: 1390002184893844352
• NII論文ID: 130007830852
• DOI: 10.1253/circrep.cr-19-0119
• ISSN: 24340790
• Web Site: https://www.jstage.jst.go.jp/article/circrep/2/4/2_CR-19-0119/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020371491
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可