Natalia Camejo-Martínez, Cecilia Castillo-Leska, Valeria Rodríguez-Saenz, Guadalupe Herrera-Álvarez, Dahiana Amarillo-Hernández, María Carolina Dörner-Cabrera, Gabriel Krygier-Waltier
{"title":"[抗 HER-2 疗法对 HER-2 阳性乳腺癌患者的心脏毒性]。","authors":"Natalia Camejo-Martínez, Cecilia Castillo-Leska, Valeria Rodríguez-Saenz, Guadalupe Herrera-Álvarez, Dahiana Amarillo-Hernández, María Carolina Dörner-Cabrera, Gabriel Krygier-Waltier","doi":"10.5281/zenodo.10278147","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Material and methods: </strong>Observational, descriptive, and retrospective study which included patients with HER-2 + BC treated with trastuzumab, trastuzumab/pertuzumab, or TDM1.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":94200,"journal":{"name":"Revista medica del Instituto Mexicano del Seguro Social","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Cardiotoxicity from anti-HER-2 therapies in patients with HER-2 positive breast cancer].\",\"authors\":\"Natalia Camejo-Martínez, Cecilia Castillo-Leska, Valeria Rodríguez-Saenz, Guadalupe Herrera-Álvarez, Dahiana Amarillo-Hernández, María Carolina Dörner-Cabrera, Gabriel Krygier-Waltier\",\"doi\":\"10.5281/zenodo.10278147\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Material and methods: </strong>Observational, descriptive, and retrospective study which included patients with HER-2 + BC treated with trastuzumab, trastuzumab/pertuzumab, or TDM1.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":94200,\"journal\":{\"name\":\"Revista medica del Instituto Mexicano del Seguro Social\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista medica del Instituto Mexicano del Seguro Social\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5281/zenodo.10278147\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista medica del Instituto Mexicano del Seguro Social","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5281/zenodo.10278147","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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。
[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.