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Cardiac Tolerability of Concurrent Administration of Trastuzumab and Anthracycline-Based Regimen as Adjuvant Chemotherapy for Breast Cancer

Background: Retrospective analysis suggests that anthracycline-containing regimens may be superior to non-anthracycline-containing regimens in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, both trastuzumab and anthracycline have cardiotoxicity, and it...

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Published in:Breast care (Basel, Switzerland) Switzerland), 2014-01, Vol.9 (1), p.46-51
Main Authors: Watanabe, Naoki, Otsuka, Shoko, Sasaki, Yoko, Shimojima, Reiko, Wani, Yoji, Uchino, Kaori
Format: Article
Language:English
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Summary:Background: Retrospective analysis suggests that anthracycline-containing regimens may be superior to non-anthracycline-containing regimens in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, both trastuzumab and anthracycline have cardiotoxicity, and it remains unclear how to use trastuzumab in combination with an anthracycline to curtail their cardiotoxicity. Patients and Methods: From 2010 to 2013, we administered weekly (q1w) paclitaxel (wP) followed by 75 mg/m 2 epirubicin, fluorouracil, and cyclophosphamide (FEC) every third week (q3w) and concurrent q1w trastuzumab (H) to 41 patients with HER2-positive breast cancer (H+ group), and wP followed by FEC100 without trastuzumab to 57 patients who were HER2-negative (H- group). We routinely assessed the left ventricular ejection fraction (LVEF) by echocardiography, at the time of initiation, after wP, and after FEC, and compared them between these 2 groups. Results: LVEF decreased from 63.2 to 60.9% (p = 0.030) in the H+ group and from 63.9 to 61.9% (p = 0.009) in the H- group. These 2 groups showed no significant difference in the reduction rate of LVEF over the period of chemotherapy (0.968 vs. 0.978: NS, p = 0.6457). There was no severe cardiotoxicity or congestive heart failure in either group. Conclusion: Concurrent administration of epirubicin (q3w, 75 mg/m 2 ) and trastuzumab showed no less cardiac tolerability in an adjuvant setting.
ISSN:1661-3791
1661-3805
DOI:10.1159/000358754