Cardiotoxicity among Patients Using Pertuzumab, Trastuzumab and Taxane with HER2-Positive Early-Stage Breast Cancer: A Single-Centre Experience
Alanood S. Algarni *
Pharmacology and Toxicology Department, Pharmacy Collage, Umm Al-Qura University, Makkah, Saudi Arabia.
Anan A. Alfi
Pharmacy Collage, Umm Al-Qura University, Saudi Arabia.
Azuf T. Turkistani
Pharmacy Collage, Umm Al-Qura University, Saudi Arabia.
Layal E. Malki
Pharmacy Collage, Umm Al-Qura University, Saudi Arabia.
Nouf F. Alghanam
Pharmacy Collage, Umm Al-Qura University, Saudi Arabia.
Shayma S. Abdulghani
Pharmacy Collage, Umm Al-Qura University, Saudi Arabia.
Majed Ramadan
King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdul Aziz Medical City, Jeddah 22384, Saudi Arabia.
Meteb Al-Foheidi
Princess Noorah Oncology Center, King Saud bin Abdulaziz University, Jeddah, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Aim: In this study, we aimed to investigate the incidence rate, risk factors, and mortality rates in patients with early-stage breast cancer using anti-HER2 (Human epidermal growth factor receptor-2) treatment.
Patients and Methods: A total of 106 patients diagnosed with human epidermal growth factor 2 (HER2)-positive early-stage breast cancer and receiving anti-HER2 treatment at King Abdulaziz Medical City (KAMC) from 2015 to 2019 were included in the analysis to assess the incidence of cardiotoxicity was collected as a retrospective study. Univariate and multivariate analyses as well as multiple exact logistic regression analysis were conducted to understand the relationships between the left ventricular ejection fraction (LVEF) and treatment combinations and comorbidities
Results: The LVEF measurements using an echocardiography method at the baseline (before any treatment) and during the anti-HER2 therapy were assessed. The results suggest that the higher the drug combination, the higher the odds ratio for the declined ejection fraction (EF) patient group. Further, patients treated with the pertuzumab and trastuzumab combination were four times more likely to have a decline in their EF than those who did not use the pertuzumab and trastuzumab drug combination (OR 4.28, 95% CI [1.68–10.91]).
Conclusion: This study demonstrated that the drug combination considered here is associated with reduced LVEF and, similarly, comorbidities were also related to EF. However, a larger study in a global patient population will confirm the present observations.
Keywords: HER2, cardiotoxicity, breast cancer, chemotherapy, left ventricular ejection fraction