Abstract 4044
Background
Radiotherapy halves the recurrence risk and reduces breast cancer death after breast sparing surgery, but it is associated cardiac morbidity and mortality (1). The EBCTCG data demonstrates an excess cardiac mortality rate ratio of 4,1% per increased Gray (Gy) whole heart dose (2). The aim of this study is to create a clinical applicable risk assessment model to predict 10-year cardiovascular mortality in female breast cancer patients.
Methods
By integration of the SCORE (Systematic COronary Risk Evaluation) risk charts and data of the EBCTCG we were able to develop cardiovascular mortality risk charts based on mean heart dose, age, systolic blood pressure, smoking-status and cholesterol for high- and low-risk regions in Europe, for contemporary mean heart doses of 2Gy, 4Gy and 8Gy.
Results
We will present tables showing the 10-year cardiovascular mortality based on mean heart dose, smoking status, age, systolic blood pressure and cholesterol for high- and low-risk regions in Europe. Below you find the risk table for 60-years old non-smoking women in low-risk regions. A 60-year old, non-smoking patient from France (low-risk region) with a cholesterol 220 mg/dl and a systolic blood pressure of 140 mmHg has a 10-year cardiovascular mortality risk of 1,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 1,1% and doubling the heart dose to 8Gy results in a risk of 1,2%. In contrast, a 65 year old smoking patient living in Bosnia (high-risk region) with a cholesterol of 260 and a systolic blood pressure of 160 mmHg has a 10-year cardiovascular mortality risk of 13,0%, adding radiotherapy with a mean heart dose of 4Gy will increase it to 14,3% and doubling the heart dose to 8Gy results in a risk of 15,7%.Table:
189P
Cholesterol: 200-250 mg/ml Mean Heart Dose | Cholesterol: 250-300 mg/ml Mean Heart Dose | |||||||
---|---|---|---|---|---|---|---|---|
SBP | 0Gy | 2Gy | 4Gy | 8Gy | 0Gy | 2Gy | 4Gy | 8Gy |
180 mmHg | 3,0 | 3,2 | 3,3 | 3,6 | 4,0 | 4,2 | 4,4 | 4,9 |
160 mmHg | 2,0 | 2,1 | 2,2 | 2,4 | 2,0 | 2,1 | 2,2 | 2,4 |
140 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 2,0 | 2,1 | 2,2 | 2,4 |
120 mmHg | 1,0 | 1,1 | 1,1 | 1,2 | 1,0 | 1,1 | 1,1 | 1,2 |
Conclusions
Integrating cardiovascular risk tables and radiotherapy data are useful for patient individualized radiotherapy and cardiovascular prevention after breast cancer treatment. (1) Lancet 2011;378(9804):1707-16. (2) J Clin Oncol 2017;35(15):1641-1649.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Vrije Universiteit Brussel.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4022 - Ribociclib (RIB) plus letrozole (LET) in male patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC) from the CompLEEment-1 trial
Presenter: Mario Campone
Session: Poster Display session 2
Resources:
Abstract
3599 - Comparative effectiveness of palbociclib plus letrozole vs letrozole for metastatic breast cancer in US real-world clinical practices
Presenter: Rachel Layman
Session: Poster Display session 2
Resources:
Abstract
901 - Pharmacokinetics (PK), safety, and efficacy of [fam-] trastuzumab deruxtecan with OATP1B/CYP3A inhibitors in subjects with HER2-expressing advanced solid tumors
Presenter: Yung-Jue Bang
Session: Poster Display session 2
Resources:
Abstract
2777 - A Phase 2 study of abemaciclib in patients (pts) with brain metastases (BM) secondary to non-small cell lung cancer (NSCLC) or melanoma (MEL).
Presenter: Solmaz Sahebjam
Session: Poster Display session 2
Resources:
Abstract
3980 - Ribociclib (RIB) + letrozole (LET) in patients (pts) with visceral metastases (VM) or bone-only metastases (BOM) in hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC): Subgroup analysis from the CompLEEment-1 trial
Presenter: Michelino De Laurentiis
Session: Poster Display session 2
Resources:
Abstract
4024 - Ribociclib (RIB) + letrozole (LET) in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor-2–negative (HER2–) advanced breast cancer (ABC) and central nervous system (CNS) metastases: Subgroup analysis from the phase 3b CompLEEment-1 trial
Presenter: Paul Cottu
Session: Poster Display session 2
Resources:
Abstract
2151 - Clinical outcome and toxicity data in patients with advanced breast cancer treated with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy in a real-world clinical setting.
Presenter: Elena Fountzilas
Session: Poster Display session 2
Resources:
Abstract
3994 - Safety and efficacy of Ribociclib (RIBO) + letrozole (LET) in patients (pts) with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2–) advanced breast cancer (ABC): Interim results from the Italian cohort of the CompLEEment-1 (C-1) study.
Presenter: Michele De Laurentiis
Session: Poster Display session 2
Resources:
Abstract
1370 - Interim Results From CompLEEment-1 (A Phase 3b Study of Ribociclib and Letrozole as First-Line Therapy for Advanced Breast Cancer in an Expanded Population): Spanish cohort results
Presenter: Javier Salvador
Session: Poster Display session 2
Resources:
Abstract
1109 - First Canadian Interim Analysis from the Phase IIIb CompLEEment-1 Ribociclib + Letrozole HR+ HER2- Advanced Breast Cancer Trial
Presenter: Cristiano Ferrario
Session: Poster Display session 2
Resources:
Abstract