The Temporal Risk of Heart Failure Associated With Adjuvant Trastuzumab in Breast Cancer Patients: A Population Study

Abstract

Adjuvant trastuzumab was associated with increased risk of new incidence of HF in breast cancer survivors during the period of adjuvant treatment but not thereafter. Routine intensive monitoring may not be necessary after completing adjuvant therapy.

Long‐term risk of congestive heart failure in younger breast cancer survivors: A nationwide study by the SMARTSHIP group

“…Contrary to previous studies that investigated the time of occurrence of CHF, which showed that most cardiotoxicities occurred within the first year after an anthracycline chemotherapeutic regimen, the rates of CHF continued to increase throughout this study . This could have been caused by the difference in the anthracycline dose.…”

“…In terms of trastuzumab, our results showed results similar to those of a previous study . One study reported that the effect of trastuzumab was not associated with long‐term CHF in breast cancer survivors …”

“…Previous studies showed that the positive predictive values of algorithms for CHF were low . The reason was that they used only International Classification of Diseases ( ICD ) codes for the algorithms, although clinicians may use the ICD codes only to rule out diseases in clinical practice . Thus, we combined the ICD diagnostic codes with related codes, such as medication, hospitalization, or specialized claim codes.…”

“…Up to now, there has been a lack of evidence about the real‐world incidence and natural course of CHF in breast cancer survivors . Previous studies were restricted to patients treated with specific regimens and had relatively small sample sizes . Other studies using claims‐based data focused on high‐risk older patients or overestimated the true incidence of CHF with less accurate disease diagnosis algorithms .…”

Tyrosine kinase-targeting drugs-associated heart failure

“…Conditional mutant mice carrying a cardiac-restricted deletion of ErbB2 (HER-2) developed cardiac chamber dilation, wall thickening, and decreased contractility (Crone et al , 2002; Ozcelik et al , 2002). Patients who have been developing cardiotoxicity while receiving trastuzumab generally improved on removal of the agent (Goldhar et al , 2015). Lapatinib seemed to be associated with lower risk but none of the trials has directly compared trastuzumab and lapatinib (Johnston et al , 2009; Blackwell et al , 2010).…”