Radiotherapy concurrent with trastuzumab is well tolerated in the adjuvant treatment of women with HER2-positive breast cancer: cardiac safety data from the NCCTG N9831 study

Perez, EA; Halyard,; Pisansky, T.; Suman, Vera J.; Dueck, A. C.; Davidson, N.; Martino, S; Kaufman, PA

doi:10.1016/s1359-6349(06)80248-x

Cited by 2 publications

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“…Thanks to high response rate of T in patients with HER-2 positive breast cancer, its concomitant use with RT or subsequent use have been widely investigated (3,5,7). However, treatmentrelated cardiac sequelae are critical to discuss.…”

Section: Discussionmentioning

confidence: 99%

“…HER-2/neu, also known as erb-B2, is a tyrosine kinase receptor located in cellular surface. Several studies have shown that overexpression of HER-2 (HR+) is associated with more aggressive and poor prognosis (2)(3)(4). Trastuzumab (T) is a monoclonal antibody against HER-2/neu receptor.…”

Section: Introductionmentioning

confidence: 99%

“…Also, it prevents cellular growth, blocking signal conduction over HER-2. It has been reported that T administration once a week or once every three weeks increases progression-free survival (PFS) and overall survival in patients with HER-2 positive breast cancer (1)(2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of cardiomyopathy with T monotherapy is 1.4%, while it significantly increases with T plus anthracyclines, particularly. Although the long-term outcomes of T-related cardiomyopathy are still unknown, it has been reported that T-related cardiomyopathy is relieved over time when the treatment is discontinued (3,(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

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The effects of hormonotherapy administered concurrent radiotherapy and trastuzumab on cardiac toxicity in rats

Cihan¹,

Arsav²

2014

Anadolu Kardiyol Derg

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Objective: This experimental study aims to investigate whether radiotherapy (RT) plus trastuzumab (T) followed by subsequent hormonotherapy increase the cumulative toxic effect on cardiac functions in rats. Methods: A total of 70 Wistar-Albino female rats with a mean weight 213±27 g were randomly divided into equal seven groups. The first group (C) underwent no procedure. The second group (RT) underwent the whole thoracic radiation including heart. The third group (T) was administered T through tail vein alone. The fourth group (RT+T+Tx) was administered T initially and the whole thoracic radiation at two hours, followed by tamoxifen at one week. The fifth group (RT+T+Le) was administered T and then underwent thoracic radiation, followed by letrozole. The sixth group (T+RT+An) was administered T and then underwent thoracic radiation, followed by anastrazole. The seventh group (T+RT+Ex) was administered T and then underwent thoracic radiation, followed by exemestane at one week. Hormonotherapy was administered to the rats in the Group 5, 6 and 7, as indicated in the Group 4. Radiation therapy was administered following T treatment at two hours as a single 12 Gy fraction. After the rats were sedated under anesthesia and sacrificed at 24 weeks, cardiac tissues were removed. Serial sections obtained following paraffin blockage were stained and the ratio of myocardial fibrosis was assessed. According to statistical analyses by the one-way ANOVA test and Tukey HSD test, a significant difference between test components. Results: At the end of the study, no loss and adverse effects were seen in any group. There was a statistically significant difference among atrium, ventricle and aorta (p<0.001). The mean value of fibrosis scores increased in the rats which underwent RT. In the assessment of atrium, a significant difference was found between RT group and RT+T+An group and also T group and RT+T+Fe group (p<0.001). In the assessment of ventricule, a statistically significant difference was observed among RT, RT+T+An and RT+T+Ex. In the assessment of aorta, the scores of RT group was significantly higher than RT+T+An and RT+T+Ex. A statistically significant difference was observed among these groups (p<0.001). Conclusion: Our study results suggested that there was no significant additional cardiotoxicity of adjuvant hormonotherapy following concomitant RT and T treatment, compared to RT in terms of cardiac fibrosis. (Anadolu Kardiyol Derg 2014; 14: 328-33)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of hormonotherapy administered concurrent radiotherapy and trastuzumab on cardiac toxicity in rats

Cihan¹,

Arsav²

2014

Anadolu Kardiyol Derg

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“…Possible factors, which may statistically influence the aesthetic outcome of breastconserving therapy, include the width of resection, re-excision, orientation of incisions, total dose for whole breast, dose gradient within the breast, tumor bed boost, additional sites for peripheral lymphatic radiation, concomitant chemotherapy, tumor size and age of the patient. 8,9 In this experimental study, we aimed to investigate whether hormonotherapy followed by concomitant use of T, a monoclonal antibody, and RT contributes to the development of radiation-induced skin fibrosis.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Hormonotherapy Following Concomitant Use of Trastuzumab and Radiation Therapy on Late Skin Toxicity

Cihan¹

2014

UHOD

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To investigate whether hormonotherapy followed by concomitant use of trastuzumab (T) and radiation therapy (RT) contributes to the development of radiation-induced skin fibrosis. 70 healthy female rats divided into seven groups: Control group (C) underwent no procedure. RT group underwent thoracic radiation (TR). T group was administered T. T+RT+Tx group was administered concomitant T and TR, followed by tamoxifen. T+RT+Le group was administered concomitant T and TR, followed by letrozole. T+RT+An group was administered concomitant T and TR, followed by anastrazole. T+RT+Ex group was administered concomitant T and TR, followed by exemestane. Trastuzumab was administered in 6 mg/kg. TR was performed two hours after T administration. Hormonotherapy was given at one week following RT. Rats were sacrificed at 24 weeks. Skin was scored in histopathological examination. Skin inflammation was most commonly seen in the RT, T+RT+Tx and T+RT+Le group. Skin fibrosis was present in all subjects exposed to RT. Control group, T and T+RT+Ex group had the lowest vascular damage scores, while RT, T+RT+Tx and T+RT+Le had the highest scores. The RT, T+RT+Tx and T+RT+Le group had the highest muscular fibrosis scores. Muscular fibrosis was lesser in T+RT+An and T+RT+Ex group. The rate of vascular damage in muscular tissue was the highest in RT, T+RT+Tx and T+RT+Le group. No vascular damage was observed in T and T+RT+Ex group. Our study results suggested that tamoxifen and letrozole following concomitant use of T and RT increased skin fibrosis, while anastrazole and exemestane reduced radiation-induced skin fibrosis.Key Words: Skin, Fibrosis, Radiation therapy,Trastuzumab, Hormonotherapy ÖZET Radyoterapi ile Eşzamanlı Trastuzumab Tedavisinden Sonra Verilen Hormonoterapinin Ciltte Gelişen Geç Toksisite Üzerine EtkisiRadyoterapi ile eşzamanlı trastuzumab tedavisinden sonra verilen hormonoterapinin ciltte radyasyon fibrozisi gelişimine katkısı olup olmayacağını araştırmaktır. 70 adet erişkin sağlıklı sıçan, 7 gruba ayrıldı. K grup (Kontrol grubu); RT grubu (Sadece radyoterapi uygulanan); T grubu (Sadece trastuzumab verilen); T+RT+Tam grubu (RT ile eş zamanlı T verildikten sonra tamoksifen verilen grup); T+RT+Le grubu (RT ile eş zamanlı T sonrası letrozol verilen); T+RT+An grubu (RT ile eş zamanlı T sonrası anastrazol verilen); T+RT+Ex grubu (RT ile eşzamanlı T sonrası exemestan) verilen grup olarak belirlendi. Trastuzumab, 6 mg/kg verildi. RT, T'den iki saat sonra, göğüs duvarına tek fraksiyonda ışınlama yapıldı. RT'den bir hafta sonra hormonoterapi ilaçları 6 ay süre ile verildi. 24 hafta sonra sıçanlar sakrifiye edildi. Deri dokusu histopatolojik olarak incelendi. Deride inflemasyon en fazla RT, T+RT+Tam ve T+RT+Le gruplarında görüldü. RT alan grupların hepsinde deride fibrosizin oluştuğu görüldü. Deride vasküler hasar skorlaması en düşük kontrol, T ve T+RT+Ex gruplarında en yüksek skorlama RT, T+RT+Tam ve T+RT+Le gruplarında bulundu. Kasta fibrosiz skorlaması en yüksek RT, T, T+RT+Tam, T+RT+Le gruplarında bulundu. T+RT+An and...

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Radiotherapy concurrent with trastuzumab is well tolerated in the adjuvant treatment of women with HER2-positive breast cancer: cardiac safety data from the NCCTG N9831 study

Cited by 2 publications

References 0 publications

The effects of hormonotherapy administered concurrent radiotherapy and trastuzumab on cardiac toxicity in rats

The effects of hormonotherapy administered concurrent radiotherapy and trastuzumab on cardiac toxicity in rats

The Effects of Hormonotherapy Following Concomitant Use of Trastuzumab and Radiation Therapy on Late Skin Toxicity

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