Trastuzumab Tied to Higher Long-Term Risk for Heart Failure

Compared with chemotherapy alone, trastuzumab is associated with a twofold increased long-term risk for heart failure in breast cancer survivors, according to a study published in the March 1 issue of JACC: Heart Failure.

Ann Banke, M.D., from Odense University Hospital in Denmark, and colleagues used the Danish Breast Cancer Cooperative Group database to identify 8,812 patients (25 percent human epidermal growth factor receptor 2 [HER2]-positive; average age, 51.7 years) who received chemotherapy, including anthracycline; those who were HER2-positive also received trastuzumab.

The researchers found that in the trastuzumab group, 60 patients had heart failure by nine years versus 51 in the group treated with chemotherapy alone. These numbers yielded an incidence rate of 5.3 and 1.4 per 1,000 patient years, respectively. For both the short and long term, the cumulative incidence of heart failure was higher in the trastuzumab group (P < 0.01), yielding adjusted hazard ratios of 8.7 for early heart failure and 1.9 for late heart failure associated with trastuzumab treatment.

"With many long-term cancer survivors, the finding of increased long-term risk of heart failure after trastuzumab treatment should be kept in mind when patients present with heart failure many years after a diagnosis of cancer.

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