Trastuzumab-related cardiotoxicity was 5-fold lower in Taiwanese women with breast cancer compared with previously published results, a study published in JAMA Oncology has shown.1

Trastuzumab is a commonly used immunotherapeutic agent used for patients with HER2-positive tumors. Previous research has demonstrated an increased risk of cardiac effects with trastuzumab, but its cardiac safety information in Asian woman is limited. Therefore, investigators sought to estimate the rate and risk of heart failure and/or cardiomyopathy in Asian women undergoing trastuzumab treatment.

For the cohort study, researchers analyzed data from 23,006 women with incident breast cancer included in the Taiwanese National Health Insurance Research Database, a nationwide claim database covering more than 99% of the entire Taiwanese population. All identified patients received chemotherapy between 2006 and 2009, of which 1066 had trastuzumab.

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Researchers found that the incidence of heart failure and/or cardiomyopathy was 4.03% among those who received trastuzumab vs 2.88% among matched controls who did not receive the anti-HER2 monoclonal antibody.

Results further showed that the median time to heart failure and/or cardiomyopathy was 456 days and 966 days in trastuzumab users and nonusers, respectively.

The study also demonstrated that trastuzumab users had an 86% increased risk of 1-year cumulative incidence of cardiac effects compared with non users (HR, 1.86; 95% CI, 1.08-3.19).

“Our study provides critical cardiac safety information of trastuzumab for Asian women with breast cancer under current treatment guidelines and label information,” the authors concluded.


Chien H-C, Yang Y-H, Bai JP. Trastuzumab-related cardiotoxic effects in Taiwanese women: a nationwide cohort study [published online ahead of print June 16, 2016]. JAMA Oncol. doi: 10.1001/jamaoncol.2016.1269.