General Poster Session
AB158. SOH21AS134. Cardiac impact of trastuzumab in HER2 positive breast cancer
Colm O’Flaherty1, Eoin Kerin1, Peter McAnena1, Matthew Davey1, Elizabeth Maher1, Atif Shahzad2, Talha Iqbal2, Mattia Lunardi2, Ray McLaughlin1, Karl Sweeney1, Carmel Malone1, Kevin Barry1,2, Aoife Lowery1,2, William Wyns2, Osama Soliman2, Michael Kerin1,2
1Department of Surgery, Galway University Hospitals, Galway, Ireland;
2The Lambe Institute for Translational Research, National University of Ireland, Galway, Galway, Ireland;
3Department of Cardiovascular Medicine, National University of Ireland, Galway, Ireland
Background: Human epidermal growth factors receptor-2 (HER2) positive breast cancer accounts for 10–25% of new diagnoses and adjuvant treatment with anti-HER2 agents such as Trastuzumab is standard of care. The cardiotoxic profile of these agents has been well established. The aim of this study was to assess the impact of anti-HER2 therapy on the cardiac profile and cardiovascular morbidity of patients measured by echocardiography (ECHO).
Methods: Consecutive female patients with HER+ BC managed in a single institution between 2005–2015 were included. Clinicopathological features of HER2 BC were determined. ECHO results were collected on all available patients and follow up was carried out using Evolve software. Heart failure was defined as ejection fraction (EF) <45% on ECHO.
Results: A total of 507 consecutive patients were included with mean age 56.9±13.7 years (23.0–95.0) and received adjuvant Trastuzumab. Median follow up was 111.5 months. One hundred and thirty patients (27%) had ECHO assessment pretreatment/at 3 months/6 months/9 months and post treatment. Trastuzumab was discontinued in 10 patients (0.5%) prior to completion of one year of treatment due to new reduction in EF <45%. Two patients (0.1%) had a new reduction in EF <45% following 1 year of Trastuzumab. There were 2 cardiovascular related mortalities recorded.
Conclusions: In patients with HER2+ breast cancer, Trastuzumab therapy may cause cardio-toxic side effects. Appropriate serial interventions, Echocardiography and cardiology input to the multidisciplinary programme will be required for this patient cohort and optimization of the regime will require prospective assessment.
Keywords: Breast cancer; human epidermal growth factors receptor-2 (HER2); trastuzumab; heart failure; echocardiography (ECHO)
Acknowledgments
Funding: None.
Conflicts of Interest: AL serves as an unpaid editorial board member of Mesentery and Peritoneum. The other authors have no conflicts of interest to declare.
Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.
doi: 10.21037/map-21-ab158
Cite this abstract as: O’Flaherty C, Kerin E, McAnena P, Davey M, Maher E, Shahzad A, Iqbal T, Lunardi M, McLaughlin R, Sweeney K, Malone C, Barry K, Lowery A, Wyns W, Soliman O, Kerin M. SOH21AS134. Cardiac impact of trastuzumab in HER2 positive breast cancer. Mesentery Peritoneum 2021;5:AB158.
