Evaluation of cardiac safety of trastuzumab treatment in patients with HER2﹣positive tumors
10.3760/cma.j.issn.1008﹣5734.2019.04.005
- VernacularTitle:曲妥珠单抗治疗HER2阳性肿瘤患者的心脏安全性评价
- Author:
Chunhui WANG
1
;
Jing LI
1
;
Wei WU
1
;
Wensi LI
1
;
Xiaoyu LI
1
;
Qianzhou LYU
1
Author Information
1. 复旦大学附属中山医院药剂科,上海,200032
- Publication Type:Journal Article
- Keywords:
Receptor,erbB﹣2;
Trastuzumab;
Cardiotoxicity;
Drug﹣related side effects and adverse reactions
- From:
Adverse Drug Reactions Journal
2019;21(4):265-272
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the cardiac safety of trastuzumab﹣containing regimens in patients with HER2﹣positive tumors. Methods The clinical data of adult patients with HER2﹣positive breast cancer,gastric cancer or gastroesophageal junction adenocarcinoma,with normal electrocardiogram and echocardiography before treatments,and treated with trastuzumab﹣containing regimens in Zhongshan Hospital Affiliated to Fudan University from January 2016 to February 2018 were collected through the hospital information system and cardiac adverse events after trastuzumab﹣containing regimens were retrospectively analyzed. ,The patients were divided into 4 groups according to the application history of antineoplastic drugs:group A ( neither anthracyclines nor fluoropyrimidines application history ), group B ( only anthracyclines application history),group C( only fluoropyrimidines application history),and group D (both anthracyclines and fluoropyrimidines application history). The occurrences of cardiac adverse events in the 4 groups were compared. Results A total of 90 patients were enrolled,including 34 males and 56 females,aged(60 ± 12)years. Of them,43 patients(47. 8% )were with breast cancer,46(51. 1% ) were with gastric cancer,and 1(1. 1% )was with gastroesophageal junction adenocarcinoma. Group A,B, C,and D comprised 11,20,52,and 7 patients,respectively. Of the 90 patients,65 patients developed 96 cases of adverse cardiac events. The incidence of adverse cardiac events was 72. 2% . The severity of cardiac adverse events was grade 1 in 91 cases and grade 2 in 5 cases. The adverse events with higher incidence were arrhythmia( 36. 7% ,33/90 ),abnormal cardiac structure ( 22. 2% ,20/90 ), valvular reflux (22. 2% ,20/90),and increased pulmonary arterial systolic pressure( 10. 0% ,9/90 ). There was no significant difference in the incidence of cardiac adverse events after trastuzumab treatment in patients with different antineoplastic drug application history among the 4 groups(all P﹥0. 05). Except for 2 patients with grade 2 sinus tachycardia whose heart rate returned to normal after treatment with beta﹣blocker,the other 63 patients did not need medical intervention. Conclusion The incidence of cardiac adverse events of trastuzumab treatment in patients with HER2﹣positive tumors was higher,but the severity of most of them were grade 1,which rarely cause serious cardiac functional or structural damage.
