The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population

Antonio Russo, Giuseppe Cicero, Rosalba Rossello, Barbara Adamo, Tindara Franchina, Giuseppa Ferraro, Giuseppina Rosaria Rita Ricciardi, Mariangela Zanghì, Nicola Caristi, Vincenzo Adamo, Sergio Rizzo

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Abstract

AbstractBackground: Breast cancer in the elderly is associated withhigh 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 elderlypatients because of its cardiotoxicity. Patients and Methods:Medical records of consecutive HER2-positive breastcancer patients aged ≥ 70 years old treated between 2005and 2010 in the participating centers were retrospectivelyreviewed. All patients underwent multidimensional geriatricassessment (MGA). Results: Among 59 patients identified,51 patients were evaluable (median age 76 years). The rateof any adverse event was 20% (10/51). The most relevant cardiacadverse event consisted of symptomatic congestiveheart failure (CHF; n = 1, 2%) followed by asymptomatic decreasesof 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 concurrentchemotherapy were associated with a higher incidence oftoxic events. Previous radiotherapy, concurrent endocrinetherapy and different trastuzumab-based regimens did notseem to influence toxicity. Conclusions: Our data suggestthat trastuzumab has a good safety profile in nonfrail womenaged 70 years and older. These favorable findings may berelated to a limited number of anthracycline pretreatments,patient selection and a close cardiologic monitoring.
Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalOncology
Volume86
Publication statusPublished - 2013

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Russo, A., Cicero, G., Rossello, R., Adamo, B., Franchina, T., Ferraro, G., Ricciardi, G. R. R., Zanghì, M., Caristi, N., Adamo, V., & Rizzo, S. (2013). The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population. Oncology, 86, 16-21.