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Cardiotoxicity of trastuzumab in patients with HER2-positive gastric cancer

 Ji Soo Park  ;  Jong-Chan Youn  ;  Chi Young Shim  ;  Geu-Ru Hong  ;  Choong-Kun Lee  ;  Jee Hyung Kim  ;  Hyung Soon Park  ;  Su Jin Heo  ;  Seung Hoon Beom  ;  Hyo Song Kim  ;  Sun Young Rha  ;  Hyun Cheol Chung  ;  Seok-Min Kang  ;  Minkyu Jung 
 ONCOTARGET , Vol.8(37) : 61837-61845, 2017 
Journal Title
Issue Date
HER2 ; cardiotoxicity ; gastric cancer ; incidence ; trastuzumab
Trastuzumab-induced cardiotoxicity (TIC) is the primary adverse event that limits the use of trastuzumab in HER2-positive breast cancer patients. However, the incidence and risk factors of TIC in HER2-positive gastric cancer are not known. Therefore, we evaluated the incidence and predictive factors of TIC in gastric cancer patients treated with trastuzumab in clinical practice. We reviewed cardiac dysfunction in HER2-positive gastric cancer patients between December 2005 and April 2015 in a prospectively-collected database that included prospective clinical trials at Yonsei Cancer Center, Republic of Korea. TIC was defined as an absolute decline in left ventricular ejection fraction (LVEF) of at least 10 percentage points from the baseline to a value less than 55%, as identified by a multiple-gated acquisition scan or an echocardiogram. Among the 115 patients, 70 patients (60.9%) received trastuzumab combined with chemotherapy, and 45 patients (39.1%) received chemotherapy alone as a first-line therapy. Symptomatic heart failure was not observed in either group, but a significant asymptomatic drop in LVEF was noted in five (7.1%) of the trastuzumab combined-group patients and in one (2.2%) chemotherapy-only group patient [hazard ratio (HR), 3.47; 95% confidence interval (CI), 0.40-29.8; P=0.257]. TIC was observed more frequently in elderly patients than in younger patients (HR, per age in year, 1.16; 95% CI, 1.02-1.31; P=0.019). Similar to prior observations in breast cancer, TIC in gastric cancer patients is not frequent or reversible. However, the asymptomatic drop in LVEF should be monitored continually in HER2-positive gastric cancer patients treated with trastuzumab, especially in elderly patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, Jee Hung(김지형) ORCID logo https://orcid.org/0000-0002-9044-8540
Kim, Hyo Song(김효송) ORCID logo https://orcid.org/0000-0002-0625-9828
Rha, Sun Young(라선영) ORCID logo https://orcid.org/0000-0002-2512-4531
Park, Ji Soo(박지수) ORCID logo https://orcid.org/0000-0002-0023-7740
Park, Hyung Soon(박형순)
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Choong-kun(이충근) ORCID logo https://orcid.org/0000-0001-5151-5096
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Chung, Hyun Cheol(정현철) ORCID logo https://orcid.org/0000-0002-0920-9471
Heo, Su Jin(허수진) ORCID logo https://orcid.org/0000-0002-0615-5869
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
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