Abstract 5385
Background
The Anti-Her 2 (AH2) drugs [trastuzumab (T.) and ertuzumab (P.)] are essential components in HER2 + Breast Cancer treatment. Although these kinds of therapies represent a breakthrough in different studies, a group of patients (p.) presented left ventricular dysfunction (LVD) in the follow-up. The vast majority recovered the left ventricular ejection fraction (LVEF) after withdrawal of treatment. We analysed prospectively a group of p. who presented a LVD after AH2 treatment. We propose that the early treatment with beta-blockers (BB), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blockers (ARB), aldosterone antagonist (AA); could help an early recovery of LVEF and allow the reintroduction of the AH2 therapy without a new risk of LVD.
Methods
We evaluated 587 consecutive p. with HER2+ breast cancer who received T. alone or with P. from January 2017 to August 2018. We evaluated LVEF with ultrasonography (US.) before treatment (t). 43 p. had developed LVD and started t. with BB [Carvedilol (C.], ACEI [Enalapril (E.)] or ARB [Valsartan (V.)], AA [eplerenone (EP.)] at the moment of HF diagnosis and kept under t. after LVEF recovery. AH2 therapies were reintroduced when the patients improved their LVEF. Follow-up was with US.: 30 days, 60 days, 3 and 6 months (m.). We used SPSS for the statistical analysis.
Results
43 p. aged 54 +/- 8, 100% female. Risk Factors: arterial hypertension 10 p., diabetes 5 p, dyslipidemia 6 p., smoking 9 p. Previous oncological therapies: doxorubicin - cyclophosphamide 22 p., paclitaxel 22 p. Median of the basal LVEF was 61.4 % and at HF diagnosis was 39.3 %. Patient's New York Heart Association (NYHA) at diagnosis moment class was: I 15 %, II 60% and III 25%. All of the p. stopped the AH2 therapy. HF t. was: C 42 patients, E 33 patients, V. 10 patients and EP. 42 patients. LVEF recovery at 30 days was 81.39 % of p, at 60 days 95.34 %, at 3 and 6 m 97.67 %. When p. recuperated the LVEF we restarted the AH2 therapy. No patients had a new LVD at 3 m. and 6 m.. Patient's NYHA class at 6 m was: I 30%, II 25% and asymptomatic 45%.
Conclusions
While the LVD related with AH2 therapies is a real problem in HER2+ breast cancer patients’ care, a timely diagnosis and t. with therapies for HF can allow LVEF recovery and specific oncological therapy continuance.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5694 - Findings from a new specialist remote Counselling Service for Neuroendocrine Neoplasm (NEN) patients and family members
Presenter: Catherine Bouvier
Session: Poster Display session 2
Resources:
Abstract
4725 - Hematologic malignancies in temozolomide-treated metastatic pancreatic neuroendocrine tumors
Presenter: Nicole Balmaceda
Session: Poster Display session 2
Resources:
Abstract
5842 - Efficacy and toxicity of combination chemotherapy with cyclophosphamide, vincristine and an anthracycline in patients with metastatic extrapulmonary neuroendocrine carcinoma
Presenter: Leonidas Apostolidis
Session: Poster Display session 2
Resources:
Abstract
1543 - An Australian multi-centre experience of the use of peptide receptor radionuclide therapy for bronchial carcinoid tumours.
Presenter: Lisi Lim
Session: Poster Display session 2
Resources:
Abstract
4175 - Extra-pulmonary (EP) high grade (HG) neuroendocrine carcinoma (NEC): real-life outcomes of fifty-eight patients from a Portuguese cancer center.
Presenter: Rita Conde
Session: Poster Display session 2
Resources:
Abstract
3274 - Efficacy of immune check-point inhibitors (ICPi) in large cell neuroendocrine tumors of lung (LCNET)
Presenter: Shira Sherman
Session: Poster Display session 2
Resources:
Abstract
3534 - HORMONET: Study of Tamoxifen in Well Differentiated Neuroendocrine Tumors and Hormone Receptor Positive Expression
Presenter: Milton Barros
Session: Poster Display session 2
Resources:
Abstract
2137 - Clinical utility of Metabolic Tumor Volume in Papillary Thyroid Carcinoma
Presenter: Norihiko Takemoto
Session: Poster Display session 2
Resources:
Abstract
3864 - Correlation of thyroglobulin (Tg) oscillations with progression-free survival (PFS) in patients with radioactive iodine-refractory (RAI-R) differentiated thyroid carcinoma (DTC) treated with multikinase inhibitors (MKI).
Presenter: Jorge Hernando Cubero
Session: Poster Display session 2
Resources:
Abstract
2820 - Analytical validation of a thyroid cancer diagnostic method based on the relative quantification of CLDN10, HMGA2 and LAMB3 expression
Presenter: Mateus Barrosfilho
Session: Poster Display session 2
Resources:
Abstract