(RxWiki News) Scientists have known for a while that some chemotherapy agents can cause heart disease in some patients. This complication is now being seen in some women taking a popular breast cancer drug.
These researchers said women who have had chemotherapy and are put on Herceptin following surgery, are at the greatest risk of heart disease.
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Researchers at Yale School of Medicine discovered this association after following 45,536 female Medicare patients with early-stage breast cancer. They conducted the study because women at risk for heart disease have typically been excluded from clinical trials testing of trastuzumab.
Herceptin is used to treat women with human epidermal growth factor receptor-2 (HER-2), a particularly aggressive form of breast cancer.
Trials with younger and healthier breast cancer patients showed that the drug extended life but also increased cardiovascular disease risks. This was especially true with women who had undergone chemotherapy using a class of drugs called anthracyclines.
For this study – researchers analyzed the associations of adjuvant (after primary treatment) trastuzumab and anthracycline therapy and heart failure and cardiomyopathy (heart muscle damage).
Herceptin use was associated with a 14 percent higher incidence of heart failure and cardiomyopathy over a 3-year period compared to women who received no adjuvant therapy.
This risk increased to nearly 24 percent for women who had received both chemotherapy and Herceptin. For those who were given only chemotherapy, the risks were 2.1 percent higher.
“Further study is needed to fully understand the benefits and risks of trastuzamab when they are used in the real-world population,” said Cary Gross, senior author of the study and director of the Yale COPPER (Cancer Cancer Outcomes, Public Policy, and Effectiveness Research) Center.
This study was published in the November 14 issue of the Journal of the American College of Cardiology.
This research was funded by an American Heart Association Grant-in-Aid Award and by a collaborative agreement sponsored by the Cardiology Service of Memorial Sloan-Kettering Cancer Center.