Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Firla, S.
Association of Trastuzumab (Herceptin)-induced Cardiotoxicity with co-morbid Disease and Pharmacotherapy in Breast Cancer Patients
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2018. pp. 97
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Pichler Martin
- Rainer Peter
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- Abstract:
- Introduction: Breast cancer is the most common cancer in women. In about 20% of cases an overexpression of the HER2 receptor can be found, which was formerly associated with a poorer outcome. Nowadays the monoclonal antibody trastuzumab presents an effective therapy option. However, its clinical use is limited by the occurrence of cardiac dysfunction. Although some risk factors are known, studies on the effect of cardioprotective therapy as a mean of prevention have delivered inconclusive results. Aim of this study is to give an overview of the incidence of cardiotoxicity in the patient group treated at the LKH Graz and to analyze possible associations between the occurrence of cardiotoxicity and co-morbid disease and co-therapy. Methods: We conducted a single-center retrospective study with invasive breast cancer patients who received trastuzumab treatment at the department of oncology at the university hospital in Graz between 2004 and 2016. 202 female patients were included in the final study. Collected data was analyzed using descriptive statistics and presented graphically. Based on the occurrence of cardiotoxicity two groups were distinguished whose parameters were compared using inductive statistics. Results: Treatment with trastuzumab was discontinued due to cardiotoxic side effects in 11.9% of patients and a relevant LVEF decrease could be observed in 12.4% of patients. Those patients had significantly higher baseline LVED dimensions and were significantly more often on ACE-inhibitor co-medication. Patients with cardiotoxicity were older, had a higher BMI and lower baseline LVEF, although these results failed to reach significance. Arterial hypertension was more frequent in the cardiotoxicity group, whereas smoking was less common. Rates for diabetes and hypercholesterolemia were similar in both groups. A higher rate of calcium channel blockers and a lower rate of statins and spironolactone could be observed in the cardiotoxicity group. Further cardiovascular medication was similar among both groups. None of these observations regarding co-morbid disease and co-therapy was statistically significant. Conclusion: Patients with cardiotoxicity had higher baseline LVEDD values and were on medication with ACE-Inhibitors more frequently. Differences between both groups regarding age, BMI, baseline LBEF and smoking rate and frequency of statin-co-medication were not statistically significant.