The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population
The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population
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DOI：
10.1159/000353450
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发表时间：
2014-01-01
期刊：
影响因子：
3.5
通讯作者：
Russo, Antonio
中科院分区：
文献类型：
--
作者：
Adamo, Vincenzo;Ricciardi, Giuseppina Rosaria Rita;Russo, Antonio
背景：老年乳腺癌与高复发率和高死亡率有关，这主要是由于治疗不足。人表皮生长因子受体2型(HER2)的过度表达在老年患者中很少见。基于曲妥珠单抗的化疗通常被老年患者拒绝，因为它的心脏毒性。患者和方法：回顾2005-2010年间参与研究中心连续治疗的70岁HER2阳性乳腺癌患者的病历。所有患者均接受多维老年评估(MGA)。结果：59例确诊患者中，51例可评价(中位年龄76岁)。不良事件发生率为20%(10/51)。最相关的心脏不良事件包括有症状的充血性心力衰竭(CHF；n=1，2%)和无症状的左心室射血分数(LVEF；n=6，12%)下降。其他毒性反应包括曲妥珠单抗输注过程中的中度过敏反应(n=3，6%)。高血压、肥胖、既往接触蒽环类药物和同时化疗与较高的毒性事件发生率相关。以前的放射治疗、同时的内分泌治疗和不同的曲妥珠单抗方案似乎没有影响毒性。结论：我们的数据表明曲妥珠单抗在70岁及以上的非虚弱女性中具有良好的安全性。这些有利的发现可能与有限的蒽环类药物预治疗、患者选择和密切的心脏病监测有关。(C)2013年S.Karger AG，巴塞尔
Background: Breast cancer in the elderly is associated with high recurrence and death rates, due mostly to undertreatment. Human epidermal growth factor receptor type 2 (HER2) overexpression is infrequent in older patients. Trastuzumab-based chemotherapy is often withheld from elderly patients because of its cardiotoxicity. Patients and Methods: Medical records of consecutive HER2-positive breast cancer patients aged >= 70 years old treated between 2005 and 2010 in the participating centers were retrospectively reviewed. All patients underwent multidimensional geriatric assessment (MGA). Results: Among 59 patients identified, 51 patients were evaluable (median age 76 years). The rate of any adverse event was 20% (10/51). The most relevant cardiac adverse event consisted of symptomatic congestive heart failure (CHF; n = 1, 2%) followed by asymptomatic decreases of left ventricular ejection fraction (LVEF; n = 6, 12%). Other toxicities included moderate hypersensitivity reactions during trastuzumab infusions (n = 3, 6%). Hypertension, obesity, prior anthracyclines exposure and concurrent chemotherapy were associated with a higher incidence of toxic events. Previous radiotherapy, concurrent endocrine therapy and different trastuzumab-based regimens did not seem to influence toxicity. Conclusions: Our data suggest that trastuzumab has a good safety profile in nonfrail women aged 70 years and older. These favorable findings may be related to a limited number of anthracycline pretreatments, patient selection and a close cardiologic monitoring. (C) 2013 S. Karger AG, Basel