[抗 HER-2 疗法对 HER-2 阳性乳腺癌患者的心脏毒性]。

Natalia Camejo-Martínez, Cecilia Castillo-Leska, Valeria Rodríguez-Saenz, Guadalupe Herrera-Álvarez, Dahiana Amarillo-Hernández, María Carolina Dörner-Cabrera, Gabriel Krygier-Waltier
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引用次数: 0

摘要

背景:HER-2阳性(+)乳腺癌(BC)占BC的20-25%,其侵袭性更强,生存率更低。自1998年曲妥珠单抗获批以来,其他HER-2靶向疗法如百妥珠单抗和曲妥珠单抗恩坦辛(TDM1)相继问世,改善了患者的生存状况。然而,心脏毒性是这些疗法的不良反应之一:目的:估计在临床医院(Hospital de Clínicas)和索里亚诺基础医院(Hospital Departamental de Soriano)接受治疗的HER-2+BC女性患者中,使用曲妥珠单抗、曲妥珠单抗/博妥珠单抗和TDM1治疗6年后心脏毒性的发生率:观察性、描述性和回顾性研究,包括接受曲妥珠单抗、曲妥珠单抗/哌妥珠单抗或TDM1治疗的HER-2 + BC患者:共纳入81例患者,心脏毒性发生率为23.4%。心脏毒性由左室射血分数(LVEF)下降>10%(57.9%)和治疗期间LVEF明显低于50%(42.1%)决定。只有一名患者出现症状性心力衰竭。63.1%因心脏毒性而中断治疗的患者能够恢复治疗。心血管病史或用药方案与心脏毒性的发生之间没有明显的关系:研究显示,心脏毒性的发生率与国际上相似。大多数患者没有出现心脏毒性,即使出现,也是无症状和可逆的。
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[Cardiotoxicity from anti-HER-2 therapies in patients with HER-2 positive breast cancer].

Background: HER-2 positive (+) breast cancer (BC) accounts for 20-25% of BC, it is more aggressive, and it has a lower survival rate. Since the approval of trastuzumab in 1998, other HER-2-targeted therapies such as pertuzumab and trastuzumab emtansine (TDM1) have been introduced, improving patient survival. However, cardiotoxicity is an adverse effect of these treatments.

Objective: To estimate the incidence of cardiotoxicity with trastuzumab, trastuzumab/pertuzumab, and TDM1 in women with HER-2 + BC treated over a 6-year period at the Hospital de Clínicas and the Hospital Departamental de Soriano.

Material and methods: Observational, descriptive, and retrospective study which included patients with HER-2 + BC treated with trastuzumab, trastuzumab/pertuzumab, or TDM1.

Results: 81 patients were included, with a cardiotoxicity incidence of 23.4%. Cardiotoxicity was determined by a > 10% decrease in left ventricular ejection fraction (LVEF) (57.9%) and a LVEF < 50% evident during treatment (42.1%). Only 1 patient presented symptomatic heart failure. 63.1% of those who discontinued treatment due to cardiotoxicity managed to resume it. No relationship was evident between cardiovascular history or the administration regimen and the development of cardiotoxicity.

Conclusion: The study showed a cardiotoxicity incidence similar to the international one. Most did not present cardiac toxicity, and if they did, it was asymptomatic and reversible.

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