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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. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
김지형(Kim, Jee Hung) ORCID logo https://orcid.org/0000-0002-9044-8540
김효송(Kim, Hyo Song) ORCID logo https://orcid.org/0000-0002-0625-9828
라선영(Rha, Sun Young) ORCID logo https://orcid.org/0000-0002-2512-4531
박지수(Park, Ji Soo) ORCID logo https://orcid.org/0000-0002-0023-7740
박형순(Park, Hyung Soon)
범승훈(Beom, Seung Hoon) ORCID logo https://orcid.org/0000-0001-7036-3753
심지영(Shim, Chi Young) ORCID logo https://orcid.org/0000-0002-6136-0136
이충근(Lee, Choong Kun)
정민규(Jung, Min Kyu) ORCID logo https://orcid.org/0000-0001-8281-3387
정현철(Chung, Hyun Cheol) ORCID logo https://orcid.org/0000-0002-0920-9471
허수진(Heo, Su Jin) ORCID logo https://orcid.org/0000-0002-0615-5869
홍그루(Hong, Geu Ru) ORCID logo https://orcid.org/0000-0003-4981-3304
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