Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients

A multicenter cohort study

Masataka Sawaki, Hirofumi Mukai, Nahomi Tokudome, Takahiro Nakayama, Naruto Taira, Toshiro Mizuno, Yutaka Yamamoto, Akiyo Horio, Toru Watanabe, Yukari Uemura, Yasuo Ohashi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background For targeting anti-HER-2, trastuzumabincorporated chemotherapy is the standard for HER-2-overexpressing breast cancer in adjuvant settings. But there are few data on trastuzumab in elderly patients. We evaluated the incidence of adverse events among an elderly population of trastuzumab-treated HER-2-positive breast cancer patients in adjuvant settings. Methods Data on 39 elderly HER-2 overexpressing breast cancer patients treated with both curative surgery and adjuvant trastuzumab were retrospectively collected from a Japanese multicenter study. The loading dose was 8 mg/kg body weight, and the maintenance dose was 6 mg/kg every 3 weeks; or the loading dose was 4 mg/kg followed by 2 mg/kg weekly as maintenance. Results After a median follow-up of 20.0 (2.4- 53.9) months, a total of 32 patients (82.1%) completed 1-year trastuzumab treatment. The median treatment duration was 12.0 months (range 2-12; mean 10.5). Adverse events occurred in 11 patients (28.2%). Four (10.2%) discontinued or interrupted treatment after experiencing toxicity. One patient died because of interstitial pneumonia. Three patients (7.7%) had congestive heart failure (CHF), one of whom had a history of angina. Three patients (7.7%) had a lower left ventricular ejection fraction (LVEF), and brain natriuretic peptide elevation was totally observed in three patients (7.7%). Three patients with lower LVEF had received chemotherapy containing doxorubicin before trastuzumab. Of the three patients, two discontinued therapy because of CHF, but all recovered with proper medication containing a diuretic agent. Conclusions Elderly patients tolerated trastuzumab well, although careful management is needed.

Original languageEnglish
Pages (from-to)253-258
Number of pages6
JournalBreast Cancer
Volume19
Issue number3
DOIs
Publication statusPublished - Jul 2012

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Multicenter Studies
Cohort Studies
Breast Neoplasms
Safety
Stroke Volume
Trastuzumab
Heart Failure
Drug Therapy
Brain Natriuretic Peptide
Interstitial Lung Diseases
Therapeutics
Diuretics
Doxorubicin
Maintenance
Incidence

Keywords

  • Breast cancer
  • Elderly
  • HER-2/neu
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Pharmacology (medical)

Cite this

Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients : A multicenter cohort study. / Sawaki, Masataka; Mukai, Hirofumi; Tokudome, Nahomi; Nakayama, Takahiro; Taira, Naruto; Mizuno, Toshiro; Yamamoto, Yutaka; Horio, Akiyo; Watanabe, Toru; Uemura, Yukari; Ohashi, Yasuo.

In: Breast Cancer, Vol. 19, No. 3, 07.2012, p. 253-258.

Research output: Contribution to journalArticle

Sawaki, M, Mukai, H, Tokudome, N, Nakayama, T, Taira, N, Mizuno, T, Yamamoto, Y, Horio, A, Watanabe, T, Uemura, Y & Ohashi, Y 2012, 'Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients: A multicenter cohort study', Breast Cancer, vol. 19, no. 3, pp. 253-258. https://doi.org/10.1007/s12282-011-0270-9
Sawaki, Masataka ; Mukai, Hirofumi ; Tokudome, Nahomi ; Nakayama, Takahiro ; Taira, Naruto ; Mizuno, Toshiro ; Yamamoto, Yutaka ; Horio, Akiyo ; Watanabe, Toru ; Uemura, Yukari ; Ohashi, Yasuo. / Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients : A multicenter cohort study. In: Breast Cancer. 2012 ; Vol. 19, No. 3. pp. 253-258.
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abstract = "Background For targeting anti-HER-2, trastuzumabincorporated chemotherapy is the standard for HER-2-overexpressing breast cancer in adjuvant settings. But there are few data on trastuzumab in elderly patients. We evaluated the incidence of adverse events among an elderly population of trastuzumab-treated HER-2-positive breast cancer patients in adjuvant settings. Methods Data on 39 elderly HER-2 overexpressing breast cancer patients treated with both curative surgery and adjuvant trastuzumab were retrospectively collected from a Japanese multicenter study. The loading dose was 8 mg/kg body weight, and the maintenance dose was 6 mg/kg every 3 weeks; or the loading dose was 4 mg/kg followed by 2 mg/kg weekly as maintenance. Results After a median follow-up of 20.0 (2.4- 53.9) months, a total of 32 patients (82.1{\%}) completed 1-year trastuzumab treatment. The median treatment duration was 12.0 months (range 2-12; mean 10.5). Adverse events occurred in 11 patients (28.2{\%}). Four (10.2{\%}) discontinued or interrupted treatment after experiencing toxicity. One patient died because of interstitial pneumonia. Three patients (7.7{\%}) had congestive heart failure (CHF), one of whom had a history of angina. Three patients (7.7{\%}) had a lower left ventricular ejection fraction (LVEF), and brain natriuretic peptide elevation was totally observed in three patients (7.7{\%}). Three patients with lower LVEF had received chemotherapy containing doxorubicin before trastuzumab. Of the three patients, two discontinued therapy because of CHF, but all recovered with proper medication containing a diuretic agent. Conclusions Elderly patients tolerated trastuzumab well, although careful management is needed.",
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AU - Mizuno, Toshiro

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AB - Background For targeting anti-HER-2, trastuzumabincorporated chemotherapy is the standard for HER-2-overexpressing breast cancer in adjuvant settings. But there are few data on trastuzumab in elderly patients. We evaluated the incidence of adverse events among an elderly population of trastuzumab-treated HER-2-positive breast cancer patients in adjuvant settings. Methods Data on 39 elderly HER-2 overexpressing breast cancer patients treated with both curative surgery and adjuvant trastuzumab were retrospectively collected from a Japanese multicenter study. The loading dose was 8 mg/kg body weight, and the maintenance dose was 6 mg/kg every 3 weeks; or the loading dose was 4 mg/kg followed by 2 mg/kg weekly as maintenance. Results After a median follow-up of 20.0 (2.4- 53.9) months, a total of 32 patients (82.1%) completed 1-year trastuzumab treatment. The median treatment duration was 12.0 months (range 2-12; mean 10.5). Adverse events occurred in 11 patients (28.2%). Four (10.2%) discontinued or interrupted treatment after experiencing toxicity. One patient died because of interstitial pneumonia. Three patients (7.7%) had congestive heart failure (CHF), one of whom had a history of angina. Three patients (7.7%) had a lower left ventricular ejection fraction (LVEF), and brain natriuretic peptide elevation was totally observed in three patients (7.7%). Three patients with lower LVEF had received chemotherapy containing doxorubicin before trastuzumab. Of the three patients, two discontinued therapy because of CHF, but all recovered with proper medication containing a diuretic agent. Conclusions Elderly patients tolerated trastuzumab well, although careful management is needed.

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