Cardiovascular sequelae of trastuzumab and anthracycline in long-term survivors of breast cancer

Small study in patients who had undergone treatment with trastuzumab ± anthracycline ≥5 years previously (n=40) found 25% had LVEF <50%, 30% had N-terminal pro-B-type natriuretic peptide >125 pg/mL, 8% had high-sensitivity cardiac troponin T >14 ng/L and 33% had new hypertension

SPS commentary:

The researchers note that to the best of our knowledge, their study is the first to assess cardiotoxicity greater than 5 years post-trastuzumab and anthracycline therapy using a comprehensive CMR protocol, cardiac biomarkers and cardiovascular risk factor assessment. As the majority of participants received both trastuzumab and anthracycline therapy, they are unable to comment on the effects of trastuzumab alone.

All of the participants in this study had normal left ventricular ejection fraction prior to treatment. Twenty-one participants were noted to have an office systolic BP >140 mmHg, of whom only 8 had a history of hypertension. Twenty-three participants (58%) had a total cholesterol >5.0 mmol/L and 17 (43%) had triglyceride level >1.7 mmol/L. Two participants (5%) had elevated HbA1c levels consistent with a new diagnosis of diabetes mellitus.

The authors say their findings “reinforce the relevance of comprehensive evaluation of cardiovascular risk factors following completion of cancer therapy, in addition to risk-stratified guidance of serial LVEF monitoring”.

 

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