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Title: Real-world impact of anti-HER2 therapy-related cardiotoxicity in patients with advanced HER2-positive breast cancer.
Austin Authors: Conduit, C;de Boer, R H;Lok, S;Gibbs, P;Malik, L;Loh, Zoe ;Yeo, Belinda ;Greenberg, S;Devitt, B;Lombard, J;Nottage, M;Collins, I;Torres, J;Nolan, M;Nott, L
Affiliation: Medical Oncology, Calvary Mater, Newcastle, Australia
Medical Oncology, Eastern Health Clinical School, Melbourne, Australia
Medical Oncology, Royal Hobart Hospital, Hobart, Australia
Cardiology, Western Health, Melbourne, Australia
Medical Oncology, Goulburn Valley Health, Shepparton, Australia
Medical Oncology, South West Healthcare, Warrnambool, Australia
Deakin University, Geelong, Australia
Medical Oncology, Royal Brisbane Hospital, Brisbane, Australia
Medical Oncology, Western Health, Melbourne, Australia
Medical Oncology
Olivia Newton-John Cancer Research Institute
Medical Oncology, Canberra Hospital, Canberra, Australia
Walter and Eliza Hall Institute of Medical Research andMedical Oncology, Melbourne Health, Melbourne, Australia
Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
Issue Date: Dec-2020
Date: 2020-08-10
Publication information: Asia-Pacific Journal of Clinical Oncology 2020; 16(6): 356-362
Abstract: Anti-HER2 therapy-related cardiotoxicity is well described in the context of clinical trials, particularly in the setting of early stage disease, but there is more limited data in advanced breast cancer and in the real world setting. A prospectively-maintained registry database with 312 consecutive patients diagnosed with HER2 positive advanced breast cancer in Australia was analysed. 287 patients (92%) received anti-HER2 therapy, 17 (6%) experienced anti-HER2 therapy-related cardiotoxicity. Patients who experienced cardiotoxicity were more likely to have ≥2 risk factors for cardiotoxicity (OR 3.9 95% CI 1.4-11.3 p = 0.01). A prior diagnosis of cardiovascular disease was significantly associated with cardiotoxicity (OR 7.1 95% CI 1.3-39.5). Cardiotoxicity resolved on imaging in 65% of patients; there was no association between severity and resolution. 11 patients (65%) received cardiologist input. Of the patients who developed cardiotoxicity, 12 patients (71%) received further anti-HER2 therapy in the first- or second-line setting without recurrent cardiotoxicity. Therapy-related cardiotoxicity is an uncommon complication of anti-HER2 therapy in the real world setting. Cardiac toxicity resolved in the majority of affected patients, and further anti-HER2 therapy was administered without recurrence of cardiac issues. Our data suggests anti-HER2 therapy can be safely given in routine care, even in patients with risk factors for toxicity.
DOI: 10.1111/ajco.13381
ORCID: 0000-0001-5258-4130
Journal: Asia-Pacific journal of clinical oncology
PubMed URL: 32779390
Type: Journal Article
Subjects: HER2 positive
breast cancer
Appears in Collections:Journal articles

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