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Comparison of left ventricle ejection fraction between breast cancer patients with double and single anti-HER2 blockade
Session:
Posters 2 - Écran 06 - IC Outros/Terapêutica
Speaker:
Ana Catarina Gomes
Congress:
CPC 2018
Topic:
K. Cardiovascular Disease In Special Populations
Theme:
30. Cardiovascular Disease in Special Populations
Subtheme:
30.6 Cardio-Oncology
Session Type:
Posters
FP Number:
---
Authors:
Ana Catarina Gomes; Charlotte Manisty; Arjun Ghosh; Mark Westwood; Tom Crake; Meredith Milles; Ana G Ferreira
Abstract
<p><strong>Introduction:</strong> Double anti-HER2 therapy including pertuzumab and trastuzumab is one of the new regimens used in early and metastatic breast cancer. Besides its known efficacy in prolonging overall survival, the long-term cardiac safety seems almost unaffected in comparison with single anti-HER2 blockade.</p> <p><strong>Aim:</strong> Our aim was to analyze the cardiac effects of single versus double anti-HER2 blockade in breast cancer females.</p> <p><strong>Methods:</strong> Retrospective study, including female patients diagnosed with HER-2 positive breast cancer. They were divided into 2 groups (trastuzumab versus trastuzumab and pertuzumab) and paired according to age and chemotherapy with or without anthracyclines. We registered the clinical information, as well as the imaging data. Only patients with at least 2 echocardiographic evaluations were included in the analysis. Patients were assessed with transthoracic echocardiogram every 3 months during trastuzumab (TZ) and every 2 months during the combination of trastuzumab and pertuzumab (PTZ). Evaluation timepoints included: T0: baseline, T1: 3 months of TZ and 2 months of PTZ, T2: 6 and 4 months, T3: 9 and 6 months, T4: 12 and 8 months, respectively.</p> <p><strong>Results:</strong> 56 female breast cancer patients included. Mean age of 57.9±11.8 years. Tumor differentiation stage: 52.5% with G3 and 27.3% with G2. 50% submitted to trastuzumab and 50% submitted to pertuzumab and trastuzumab. 66.1% submitted to docetaxel, 57.6% previously submitted to anthracycline-based chemotherapy. 37.1% submitted to radiotherapy.</p> <p>Comparison of left ventricle ejection fraction (LVEF) between patients with TZ versus PTZ: T0: 61.1±6.8 vs 60.0±5.1 (p=0.57), T1: 59.5±5.7 vs 56.8±6.8 (p=0.25), T2: 59.5±5.1 vs 58.1±6.3 (p=0.47), T3: 58.2±7.5 vs 55.7±6.38 (p=0.88), T4: 59.3±3.9 vs 56.5±2.38 (p=0.361). Only two patients (3.6%) developed cardiotoxicity during the treatment: both were submitted to anthracycline-based CT, docetaxel and double anti-HER2 blockade.</p> <p>No diferences between patients with and without anthracyclines, in the different timepoints, were found (T0: p=0.10; T1: p=0.92, T2: p=0.71; T3: p=0.54; T4 p=0.45; T5: p=0.96).</p> <p>There is a statistical difference in the LVEF between patients with and without docetaxel in T2: 60.04±4.8 vs 55.6±6.8, p=0.04. No differences were found in other timepoints: T0: p= 0.59; T1: p=0.59; T3: p=0.43; T4 p=0.14; T5: p=0.51).</p> <p> </p> <p><strong>Conclusion:</strong> There are no significant differences in mean LVEF between groups with TZ and PTZ. The incidence of cardiotoxicity was 3.6%. The use of docetaxel seems to further decrease the LVEF. </p>
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