This site is intended for health professionals only

Published on 9 August 2007

Share this story:

Warning on trastuzumab heart risks


Adjuvant trastuzumab provides substantial benefits to patients with human epidermal growth factor receptor 2 positive breast cancer, but competing immediate and long-term cardiovascular risks are a great concern, so continued cardiac follow-up of these women is of critical importance.

Such are the conclusions of a paper published in the Journal of Clinical Oncology.

The research assessed the spectrum and reversibility of cardiotoxicity observed in the following adjuvant trastuzumab trials:

• National Surgical Adjuvant Breast and Bowel Project (NSABP) B-31.

• North Central Cancer Treatment Group N9831.

• Herceptin Adjuvant Breast Cancer International Research Group 006.

• Finland Herceptin trials.

The following findings were reported:

• Up to 4% of patients enrolled in the adjuvant trials experienced severe congestive heart failure during treatment.

• Early-stopping rules in the trials that identified an unacceptable level of cardiotoxicity were never reached, but despite this a large number of patients on these trials experienced some form of cardiotoxicity that ultimately required discontinuation of trastuzumab.

• Some 14% of patients in the NSABP B-31 trial discontinued trastuzumab because of asymptomatic decreases in left ventricular ejection fraction (LVEF).

• Results of follow-up cardiac evaluations of patients diagnosed with any degree of cardiotoxicity in the NSABP B-31 trial document that a clinically significant proportion of patients have sustained decreases in their LVEF to <50%.

J Clin Oncol 2007;25:3525-33


Most read

Latest Issue

Be in the know
Subscribe to Hospital Pharmacy Europe newsletter and magazine