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

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

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Abstract

Abstract 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.
Original languageEnglish
Pages (from-to)16-21
Number of pages6
JournalOncology
Volume86
Publication statusPublished - 2013

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Breast Neoplasms
Population
Anthracyclines
Stroke Volume
Patient Selection
Medical Records
Trastuzumab
Hypersensitivity
Radiotherapy
Obesity
Hypertension
Safety
Recurrence
Drug Therapy
Mortality
Incidence

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population. / Russo, Antonio; Cicero, Giuseppe; Rizzo, Sergio; Caristi, Nicola; Adamo, Vincenzo; Rossello, Rosalba; Adamo, Barbara; Franchina, Tindara; Ferraro, Giuseppa; Ricciardi, Giuseppina Rosaria Rita; Zanghì, Mariangela.

In: Oncology, Vol. 86, 2013, p. 16-21.

Research output: Contribution to journalArticle

Russo, A, Cicero, G, Rizzo, S, Caristi, N, Adamo, V, Rossello, R, Adamo, B, Franchina, T, Ferraro, G, Ricciardi, GRR & Zanghì, M 2013, 'The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population', Oncology, vol. 86, pp. 16-21.
Russo, Antonio ; Cicero, Giuseppe ; Rizzo, Sergio ; Caristi, Nicola ; Adamo, Vincenzo ; Rossello, Rosalba ; Adamo, Barbara ; Franchina, Tindara ; Ferraro, Giuseppa ; Ricciardi, Giuseppina Rosaria Rita ; Zanghì, Mariangela. / The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population. In: Oncology. 2013 ; Vol. 86. pp. 16-21.
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abstract = "Abstract 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.",
author = "Antonio Russo and Giuseppe Cicero and Sergio Rizzo and Nicola Caristi and Vincenzo Adamo and Rosalba Rossello and Barbara Adamo and Tindara Franchina and Giuseppa Ferraro and Ricciardi, {Giuseppina Rosaria Rita} and Mariangela Zangh{\`i}",
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T1 - The Risk of Toxicities from Trastuzumab, Alone or in Combination, in an Elderly Breast Cancer Population

AU - Russo, Antonio

AU - Cicero, Giuseppe

AU - Rizzo, Sergio

AU - Caristi, Nicola

AU - Adamo, Vincenzo

AU - Rossello, Rosalba

AU - Adamo, Barbara

AU - Franchina, Tindara

AU - Ferraro, Giuseppa

AU - Ricciardi, Giuseppina Rosaria Rita

AU - Zanghì, Mariangela

PY - 2013

Y1 - 2013

N2 - Abstract 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.

AB - Abstract 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.

UR - http://hdl.handle.net/10447/99179

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