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Heart Failure in Older Breast Cancer Patients Linked to Herceptin (Trastuzumab)

Yale researchers find 14% increase in heart failure or cardiomyopathy over 3 years (Nov. 14)

Heart failure is a relatively common complication in older women with breast cancer, but the risk is even higher in patients treated with adjuvant trastuzumab (Herceptin, Genentech), according to researchers at the Yale University School of Medicine. The new findings were published in the Journal of the American College of Cardiology.

The Yale team conducted the study because older women at higher risk of decreased heart function were often excluded from randomized clinical trials of trastuzumab, which is used to treat breast tumors that over-express human epidermal growth factor receptor-2 (HER-2). Previous clinical trials in younger, healthier women showed improved survival but also increased heart complications linked to trastuzumab, especially when combined with anthracycline chemotherapy.

The researchers examined the association between the use of adjuvant trastuzumab and anthracycline therapy and heart failure and cardiomyopathy — the most serious cardiotoxic complications — in 45,536 female Medicare beneficiaries with early-stage breast cancer. The use of trastuzumab has increased from 2.6% of the women who received any adjuvant therapy in 2000 to 22.6% in 2007.

The team found that, compared with patients who received no adjuvant chemotherapy or trastuzumab, the use of trastuzumab was associated with a 14.0% higher adjusted incidence rate for heart failure or cardiomyopathy over 3 years. Patients who received both trastuzumab and anthracycline had a 23.8% higher rate, and those treated with anthracycline chemotherapy alone had a 2.1% higher rate.

Source: Yale University; November 14, 2012.

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