CN87 - Risk stratification for cardiotoxicity and follow-up in breast cancer patients treated with anthracycline and/or trastuzumab: An exploratory analysis of patient records

Background

Cardio-oncology guidelines recommend systematic cardiac risk stratification prior to initiating cancer treatment, especially for treatments with anthracycline and/or trastuzumab. The of patients at high or very high risk for cardiotoxicity, requiring close monitoring during cancer treatment, is lacking.

Methods

We conducted an observational, descriptive study using electronic patient records from 2 Belgian hospitals. The study was carried out in patients who commenced anthracycline and/or trastuzumab treatment between January and September 2023, with data collected for at least 6 months post-treatment initiation. ESC guidelines for risk stratification guided data collection: medical history, risk factors, biomarkers, imaging, and follow-up data including cardiotoxicity, cardioprotective therapy, treatment interruption, etc. Descriptive statistical analysis and univariate logistic regression analysis were performed.

Results

Data were collected from 77 female patients, with the majority classified as low (N=39; 50.6%) or medium risk (N=25; 32.5%) of cardiotoxicity. Twelve (15.6%) patients were classified as high risk and one (1.3%) patient as very high risk. Among these high or very high risk patients, eight (10.3%) experienced treatment interruption or dose reduction, and three (3.9%) were hospitalized for heart failure. High or very high risk patients were more likely (9.04 odds; p=0.009) to initiate cardioprotective treatment or experience symptomatic heart failure (18.9 odds; p=0.015).

Conclusions

In a small sample over a short period, a notable proportion of breast cancer patients were identified as high or very high risk for cardiotoxicity during anthracycline/trastuzumab therapy. These findings underscore the importance for adhering to ESC recommendations for systematic risk stratification.

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.