Clinical Research Papers:
Association between obesity and trastuzumab-related cardiac toxicity in elderly patients with breast cancer
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Hai-Yan Wang1, Bei-Bei Yin2, Dan-Yan Jia3 and Ying-Long Hou4
1Department of Echocardiography, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
2Department of Oncology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
3Jinan Medical Emergency Center, Jinan, Shandong Province, China
4Department of Cardiology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, Shandong Province, China
Hai-Yan Wang, email: [email protected]
Keywords: obesity, breast cancer, elderly patients, trastuzumab, cardiac toxicity
Abbreviations: HER2, human epidermal growth factor receptor2; WIC, Charlson’s weighted index of comorbidities; BMI, body mass index; LVEF, left ventricular ejection fraction; CTCAE, Common Terminology Criteria for Adverse Events
Received: November 30, 2016 Accepted: April 25, 2017 Published: May 11, 2017
Purpose: Trastuzumab can improve the prognosis for patients with breast cancer, but its related cardiac toxicity is concerning. This study aimed to identify the risk factors associated with trastuzumab-related cardiac toxicity in elderly patients with HER2-positive breast cancer.
Patients and methods: A total of 133 elderly (≥ 65 years) patients who were diagnosed with breast cancer between June 1, 2007, and January 31, 2016, and received trastuzumab treatment were retrospectively reviewed. Cardiac events were defined as: (1) LVEF reduction of >10% from baseline echocardiography, (2) reduction of LVEF to <50%, and (3) signs and symptoms of heart failure as defined by the Common Terminology Criteria for Adverse Events (CTCAE) accompanied by a decrease in the LVEF. Univariate and multivariate regression analyses were used to determine the contribution of different clinical variables to trastuzumab-related cardiac events.
Results: The median age of the cohort was 71.0 years (range, 65–81 years). The median follow-up period for measurement of left ventricular ejection fraction was 11.0 months (range, 2–71 months). Fifteen patients (11.2%) experienced cardiac events during the follow-up. Multivariate regression analysis revealed that obesity (odd ratio[OR], 4.706; 95% CI, 1.984-10.147; P = 0.002) was a statistically significant risk factor associated with cardiac events.
Conclusion: Obesity is an independent risk factor for trastuzumab-related cardiac toxicity in elderly patients with breast cancer, receiving trastuzumab. Further studies are needed to establish the independent predictive value of obesity on cardiotoxicity in these patients.
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