Author(s): Omalkhair A M Abulkhair, Ahmed Gasmelseed, Shabab Al Otaibi
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Background: Trastuzumab is an important agent in the treatment of both adjuvant and metastatic breast cancer with known cardio toxicity. Cardio toxicity is defined as reduction in left ventricular ejection fraction (LVEF) of > 5% with signs and symptoms of heart failure (HF) or > 10% without such symptoms. Methods: Retrospective review of all breast cancer patients treated in King Abdulaziz Medical City with trastuzumab for adjuvant and metastatic setting from 2003 to 2012. 150 cases were identified, patients with good quality echocardiogram and base line LVEF > 55% were included (104). Patients had base line, then 3 monthly echocardiogram thereafter. Results: Studied patients showed that median age was 49 (43 - 58) years. There was a relevant decline in LVEF in 16 patients (15.38%), after mean exposure duration of 15 months. The study also revealed significant difference in EF decline between diabetic and non diabetic receiving herceptin (31.82% and 10.98% respectively, p-value 0.0213), and in 64.71% with hypercholesrolemia compared to 5.75% in those with normal cholesterol (p-value 0.0001). Conclusions: Given the limitations of this small retrospective review, we have shown that the prevalence of cardio toxicity in our patients is higher than published figures. Also, we have shown a significant correlation between diabetes, hyperlipidimia and cardio toxicity in trastuzumab treated patients. Such patients might need to be closely monitored for cardio toxicity.
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This article was published in Journal of Clinical Oncology
and referenced in Immunotherapy: Open Access