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Predictors of cardiotoxicity after chemotherapy with transtuzumab
Session:
Painel 12 -Cardio-Oncologia / Farmacologia 1
Speaker:
Pedro von Hafe Leite
Congress:
CPC 2020
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:
Pedro Von Hafe Leite; Bebiana Faria; Geraldo Dias; Ana Filipa Cardoso; Tamara Pereira; Liliana Oliveira; Sofia Rolo; Ilda Faustino; Alexandra Teixeira; Jorge Silva; António Lourenço
Abstract
<p><strong>Background:</strong> Trastuzumab is a monoclonal antibody that targets the human epidermal growth factor receptor 2 (HER2). For the 15 to 20 percent of patients with breast cancer whose tumors overexpress HER2, trastuzumab therapy is important in the treatment of both early and advanced disease. Its use results in a risk for cardiotoxicity, which is, typically, manifested by left ventricular dysfunction (LVD) and heart failure (HF) that is usually reversible with trastuzumab interruption and/or treatment with HF therapies</p> <p><strong>Purpose:</strong> To identify the predictors of cardiotoxicity during follow-up of a population under treatment with trastuzumab.</p> <p><strong>Methods:</strong> Unicentric, retrospective study including all patients, from January 2018 to November 2019, who were treated with trastuzumab and developed clinical or subclinical LVD. And a control group of 37 patients who received trastuzumab, without LVD. LVD was defined by decline in initial ejection fraction (EF) of at least 5% to <55% with signs and symptoms of heart failure or asymptomatic decrease in EF of at least 10% to <55%, or decrease in global longitudinal strain > 15%. Cardiovascular risk factors and treatment regimens were analyzed.</p> <p><strong>Results:</strong> Mean age is 54.59 ± 9.21 years in the group with LVD and 55.95 ± 10.25 in the control group.</p> <p>Of the 130 patients treated with trastuzumab from January 2018 to December 2019, 13.08% (n=17) developed LVD.</p> <p>There was an association between the occurrence of LVD and concomitant treatment with anthracyclines (100% vs 76.30%, p = 0.044) and with tobacco consumption (23.50% vs 2.60%, p = 0.028).</p> <p>There was no statistically significant difference in the two groups regarding the mean age, contrary to what is described in the literature.</p> <p>Concurrent treatment with trastuzumab and adjuvant radiation therapy, or another drug regimen, does not increase the risk of developing cardiotoxicity.</p> <p><strong>Conclusion:</strong> Concomitant treatment with anthracyclines and tobacco consumption were predictors of left ventricular dysfunction in patients with tumor treated with trastuzumab. Results reinforce the importance of tighter follow-up in patients with these risk factors.</p> <p> </p>
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