Incidence of cardiac events slightly higher with trastuzumab

the Oncology Nurse Advisor take:

The cumulative incidence of cardiac events (CE) at 6 years was slightly higher in patients with HER2-positive early breast cancer receiving trastuzumab, a new study published online ahead of print in the Journal of Clinical Oncology has shown.

For the study, patients received adjuvant doxorubicin plus cyclophosphamide followed by either weekly paclitaxel (arm A), paclitaxel then trastuzumab (arm B), or paclitaxel plus trastuzumab followed by trastuzumab alone (arm C).

Results showed that the cumulative incidence of cardiac events was 0.6% in arm A, 2.8% in arm B, and 3.4% in arm C.

Researchers found that left ventricular ejection fraction (LVEF) recovered in the majority of patients that developed congestive heart failure.

The study also demonstrated that age 60 years or older, LVEF <65% at baseline, and use of antihypertensive medications were associated with an increased risk of cardiac events in patients receiving trastuzumab.

“The cumulative incidence of CE at 6 years was slightly higher with the addition of trastuzumab; however, the late development of CE is infrequent,” the authors conclude. “Trastuzumab (in the context of anthracycline- and taxane-based therapy) continues to have a favorable benefit-risk ratio.”