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Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab

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Banke, A, Fosbøl, EL, Ewertz, M, Videbæk, L, Dahl, JS, Poulsen, MK, Cold, S, Jensen, M-B, Gislason, GH, Schou, M & Møller, JE 2019, 'Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab' JACC. Heart failure, bind 7, nr. 3, s. 217-224. https://doi.org/10.1016/j.jchf.2018.09.001

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Author

Banke, Ann ; Fosbøl, Emil L ; Ewertz, Marianne ; Videbæk, Lars ; Dahl, Jordi S ; Poulsen, Mikael Kjær ; Cold, Søren ; Jensen, Maj-Britt ; Gislason, Gunnar H ; Schou, Morten ; Møller, Jacob E. / Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab. I: JACC. Heart failure. 2019 ; Bind 7, Nr. 3. s. 217-224.

Bibtex

@article{a3ec448d9a17457a9afc77210cdc9757,
title = "Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab",
abstract = "Objectives: This study sought to evaluate the long-term risk of developing heart failure (HF) in patients receiving trastuzumab therapy. Background: Trastuzumab has improved the prognosis in patients with HER2-positive breast cancer, but it can induce left ventricular dysfunction with reduced ejection fraction or HF during treatment. The long-term risk of HF is less well described. Methods: In a nationwide Danish retrospective cohort study, 9,901 patients scheduled for adjuvant treatment for early-stage breast cancer were identified in the Danish Breast Cancer Cooperative Group database. Of these, 8,812 patients (25{\%} HER2-positive; 51.7 ± 8.5 years of age) received chemotherapy including anthracycline; and if they were HER2 positive, trastuzumab was added. The primary endpoint was a diagnosis of HF assessed before and after 18 months in a landmark analysis to distinguish short- and long-term risks. Results: Median follow-up was 5.4 years (interquartile range [IQR]: 4.1 to 6.8 years). In the trastuzumab group, 60 patients had HF by 9 years versus 51 in the group who were treated with chemotherapy alone, corresponding to incidence rates per 1,000 patient years of 5.3 (95{\%} confidence interval [CI]: 4.1 to 6.8) versus 1.4 (95{\%} CI: 1.1 to 1.8), respectively. The cumulative incidence of HF was higher in the trastuzumab group at both the short- and long-term (p < 0.01), yielding adjusted hazard ratios of 8.7 (95{\%} CI: 4.6 to 16.5; p < 0.01) for early HF and 1.9 (95{\%} CI: 1.2 to 3.3; p = 0.01) for late HF associated with trastuzumab treatment. Conclusions: Trastuzumab treatment is associated with a 2-fold increased risk of late HF compared with chemotherapy treatment alone.",
keywords = "breast cancer, cardiotoxicity, epidemiology, heart failure, trastuzumab",
author = "Ann Banke and Fosb{\o}l, {Emil L} and Marianne Ewertz and Lars Videb{\ae}k and Dahl, {Jordi S} and Poulsen, {Mikael Kj{\ae}r} and S{\o}ren Cold and Maj-Britt Jensen and Gislason, {Gunnar H} and Morten Schou and M{\o}ller, {Jacob E}",
note = "Copyright {\circledC} 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.jchf.2018.09.001",
language = "English",
volume = "7",
pages = "217--224",
journal = "JACC: Heart Failure",
issn = "2213-1779",
publisher = "Elsevier BV",
number = "3",

}

RIS

TY - JOUR

T1 - Long-Term Risk of Heart Failure in Breast Cancer Patients After Adjuvant Chemotherapy With or Without Trastuzumab

AU - Banke, Ann

AU - Fosbøl, Emil L

AU - Ewertz, Marianne

AU - Videbæk, Lars

AU - Dahl, Jordi S

AU - Poulsen, Mikael Kjær

AU - Cold, Søren

AU - Jensen, Maj-Britt

AU - Gislason, Gunnar H

AU - Schou, Morten

AU - Møller, Jacob E

N1 - Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Objectives: This study sought to evaluate the long-term risk of developing heart failure (HF) in patients receiving trastuzumab therapy. Background: Trastuzumab has improved the prognosis in patients with HER2-positive breast cancer, but it can induce left ventricular dysfunction with reduced ejection fraction or HF during treatment. The long-term risk of HF is less well described. Methods: In a nationwide Danish retrospective cohort study, 9,901 patients scheduled for adjuvant treatment for early-stage breast cancer were identified in the Danish Breast Cancer Cooperative Group database. Of these, 8,812 patients (25% HER2-positive; 51.7 ± 8.5 years of age) received chemotherapy including anthracycline; and if they were HER2 positive, trastuzumab was added. The primary endpoint was a diagnosis of HF assessed before and after 18 months in a landmark analysis to distinguish short- and long-term risks. Results: Median follow-up was 5.4 years (interquartile range [IQR]: 4.1 to 6.8 years). In the trastuzumab group, 60 patients had HF by 9 years versus 51 in the group who were treated with chemotherapy alone, corresponding to incidence rates per 1,000 patient years of 5.3 (95% confidence interval [CI]: 4.1 to 6.8) versus 1.4 (95% CI: 1.1 to 1.8), respectively. The cumulative incidence of HF was higher in the trastuzumab group at both the short- and long-term (p < 0.01), yielding adjusted hazard ratios of 8.7 (95% CI: 4.6 to 16.5; p < 0.01) for early HF and 1.9 (95% CI: 1.2 to 3.3; p = 0.01) for late HF associated with trastuzumab treatment. Conclusions: Trastuzumab treatment is associated with a 2-fold increased risk of late HF compared with chemotherapy treatment alone.

AB - Objectives: This study sought to evaluate the long-term risk of developing heart failure (HF) in patients receiving trastuzumab therapy. Background: Trastuzumab has improved the prognosis in patients with HER2-positive breast cancer, but it can induce left ventricular dysfunction with reduced ejection fraction or HF during treatment. The long-term risk of HF is less well described. Methods: In a nationwide Danish retrospective cohort study, 9,901 patients scheduled for adjuvant treatment for early-stage breast cancer were identified in the Danish Breast Cancer Cooperative Group database. Of these, 8,812 patients (25% HER2-positive; 51.7 ± 8.5 years of age) received chemotherapy including anthracycline; and if they were HER2 positive, trastuzumab was added. The primary endpoint was a diagnosis of HF assessed before and after 18 months in a landmark analysis to distinguish short- and long-term risks. Results: Median follow-up was 5.4 years (interquartile range [IQR]: 4.1 to 6.8 years). In the trastuzumab group, 60 patients had HF by 9 years versus 51 in the group who were treated with chemotherapy alone, corresponding to incidence rates per 1,000 patient years of 5.3 (95% confidence interval [CI]: 4.1 to 6.8) versus 1.4 (95% CI: 1.1 to 1.8), respectively. The cumulative incidence of HF was higher in the trastuzumab group at both the short- and long-term (p < 0.01), yielding adjusted hazard ratios of 8.7 (95% CI: 4.6 to 16.5; p < 0.01) for early HF and 1.9 (95% CI: 1.2 to 3.3; p = 0.01) for late HF associated with trastuzumab treatment. Conclusions: Trastuzumab treatment is associated with a 2-fold increased risk of late HF compared with chemotherapy treatment alone.

KW - breast cancer

KW - cardiotoxicity

KW - epidemiology

KW - heart failure

KW - trastuzumab

U2 - 10.1016/j.jchf.2018.09.001

DO - 10.1016/j.jchf.2018.09.001

M3 - Journal article

VL - 7

SP - 217

EP - 224

JO - JACC: Heart Failure

JF - JACC: Heart Failure

SN - 2213-1779

IS - 3

ER -

ID: 56977757