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Profile of patients with early HER2 positive breast cancer who developed cardiotoxicity during adjuvant trastuzumab in the University Hospital for Tumors

Cardiotoxicity during trastuzumab therapy is most often manifested as a decrease in left ventricular ejection fraction (LVEF) ≥ 5% with persistent symptoms or ≥ 10% without symptoms. During adjuvant trastuzumab in University Hospital for Tumors, patients are sent every 3 months to a control echocardiography to medical cardiotoxicity tracking. We analyzed the profi le of patients with early HER2 positive breast cancer who developed cardiotoxicity during adjuvant trastuzumab in our institution. A retrospective review of medical records from the Clinic for cardiotoxicity monitoring in University Hospital for Tumors was conducted from 2009 to 2017 and patients with early HER2 positive breast cancer, who during adjuvant trastuzumab temporarily or permanently discontinued treatment due to the development of cardiotoxicity, were selected. From a total of 796 patients who underwent adjuvant treatment with trastuzumab 42 (5.28%) developed cardiotoxicity, which was reversible in 22 (52.38%), and therapy was only temporarily discontinued, and in 20 (47.62%) irreversible forcing trastuzumab treatment withdrawal. The median occurrence of cardiotoxicity was after seven cycles of trastuzumab, respectively after 5.5 months of trastuzumab treatment. Patients were compared with regard to: 1) Age, with the hypothesis that advanced age is associated with a higher incidence of cardiotoxicity, 2) Side of adjuvant radiotherapy treatment, with the hypothesis of a higher incidence of cardiotoxicity in patients with left sided breast cancer, and 3) Body mass index (BMI), with the hypothesis that BMI increases the incidence of cardiotoxicity. Analysis of medical records revealed that among 42 patients who developed cardiotoxicity during trastuzumab treatment, 14 patients (33.33%) were older than 60 years in the time of diagnosis, 21 (50%)had a tumor in the left breast with adjuvant radiotherapy treatment performed on the left side of the chest and 23 of them (54.76%) had a body mass index greater than 24.99, which according to world literature is considered overweight. The results correspond to data that are listed in the available literature.

trastuzumab, cardiotoxicity, early breast cancer, age, body mass index

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