The effect of trastuzumab on cardiac function in patients with HER2 ‐positive metastatic breast cancer and reduced baseline left ventricular ejection fraction
Article Swipe
Nathalie I. Bouwer
,
Tessa G. Steenbruggen
,
Hánah N. Rier
,
Jos Kitzen
,
Carolien H. Smorenburg
,
Marlies L. van Bekkum
,
Paul C. de Jong
,
Jan C. Drooger
,
Cynthia Holterhues
,
Marcel J.M. Kofflard
,
Eric Boersma
,
Gabe S. Sonke
,
Mark‐David Levin
,
Agnes Jager
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1002/ijc.34024
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1002/ijc.34024
We investigated the effect of trastuzumab on cardiac function in a real‐world historic cohort of patients with HER2‐positive metastatic breast cancer (MBC) with reduced baseline left ventricular ejection fraction (LVEF). Thirty‐seven patients with HER2‐positive MBC and baseline LVEF of 40% to 49% were included. Median LVEF was 46% (interquartile range [IQR] 44%‐48%) and median follow‐up was 18 months (IQR 9‐34 months). During this period, the LVEF did not worsen in 24/37 (65%) patients, while 13/37 (35%) patients developed severe cardiotoxicity defined as LVEF <40% with median time to severe cardiotoxicity of 7 months (IQR 4‐10 months) after beginning trastuzumab. Severe cardiotoxicity was reversible (defined as LVEF increase to a value <5%‐points below baseline value) in 7/13 (54%) patients, partly reversible (defined as absolute LVEF increase ≥10%‐points from nadir to a value >5%‐points below baseline) in 3/13 (23%) patients and irreversible (defined as absolute LVEF increase <10%‐points from nadir and to a value >5%‐points below baseline) in 3/13 (23%) patients. Likelihood of reversibility was numerically higher in patients who received cardio‐protective medications (CPM), including ACE‐inhibitors, beta‐blockers and angiotensine‐2 inhibitors, compared to those who did not receive any CPM (71% vs 13%, P = .091). Sixty‐five percent of patients who received trastuzumab for HER2‐positive MBC did not develop severe cardiotoxicity during a median follow‐up of 18 months, despite having a compromised baseline LVEF. If severe cardiotoxicity occurred, it was at least partly reversible in more than two‐thirds of the cases. Risks and benefits of trastuzumab use should be balanced carefully in this vulnerable population.
Related Topics
Concepts
Ejection fraction
Medicine
Cardiotoxicity
Trastuzumab
Interquartile range
Internal medicine
Cardiology
Breast cancer
Cardiac function curve
Metastatic breast cancer
Heart failure
Cancer
Chemotherapy
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ijc.34024
- OA Status
- green
- Cited By
- 5
- References
- 13
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4223455363
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4223455363Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1002/ijc.34024Digital Object Identifier
- Title
-
The effect of trastuzumab on cardiac function in patients with
HER2 ‐positive metastatic breast cancer and reduced baseline left ventricular ejection fractionWork title - Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-04-11Full publication date if available
- Authors
-
Nathalie I. Bouwer, Tessa G. Steenbruggen, Hánah N. Rier, Jos Kitzen, Carolien H. Smorenburg, Marlies L. van Bekkum, Paul C. de Jong, Jan C. Drooger, Cynthia Holterhues, Marcel J.M. Kofflard, Eric Boersma, Gabe S. Sonke, Mark‐David Levin, Agnes JagerList of authors in order
- Landing page
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https://doi.org/10.1002/ijc.34024Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/9320802Direct OA link when available
- Concepts
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Ejection fraction, Medicine, Cardiotoxicity, Trastuzumab, Interquartile range, Internal medicine, Cardiology, Breast cancer, Cardiac function curve, Metastatic breast cancer, Heart failure, Cancer, ChemotherapyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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5Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 1, 2022: 1Per-year citation counts (last 5 years)
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13Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.after | 97 |
| abstract_inverted_index.below | 112, 133, 154 |
| abstract_inverted_index.least | 229 |
| abstract_inverted_index.nadir | 128, 148 |
| abstract_inverted_index.range | 50 |
| abstract_inverted_index.those | 181 |
| abstract_inverted_index.value | 110, 131, 152 |
| abstract_inverted_index.while | 74 |
| abstract_inverted_index.(CPM), | 172 |
| abstract_inverted_index..091). | 193 |
| abstract_inverted_index.4‐10 | 95 |
| abstract_inverted_index.9‐34 | 60 |
| abstract_inverted_index.During | 62 |
| abstract_inverted_index.Median | 45 |
| abstract_inverted_index.Severe | 100 |
| abstract_inverted_index.breast | 20 |
| abstract_inverted_index.cancer | 21 |
| abstract_inverted_index.cases. | 238 |
| abstract_inverted_index.cohort | 14 |
| abstract_inverted_index.during | 209 |
| abstract_inverted_index.effect | 4 |
| abstract_inverted_index.having | 217 |
| abstract_inverted_index.higher | 165 |
| abstract_inverted_index.median | 54, 86, 211 |
| abstract_inverted_index.months | 58, 93 |
| abstract_inverted_index.partly | 119, 230 |
| abstract_inverted_index.severe | 79, 89, 207, 223 |
| abstract_inverted_index.should | 245 |
| abstract_inverted_index.value) | 114 |
| abstract_inverted_index.worsen | 69 |
| abstract_inverted_index.<40% | 84 |
| abstract_inverted_index.(LVEF). | 30 |
| abstract_inverted_index.cardiac | 8 |
| abstract_inverted_index.defined | 81 |
| abstract_inverted_index.despite | 216 |
| abstract_inverted_index.develop | 206 |
| abstract_inverted_index.months) | 96 |
| abstract_inverted_index.months, | 215 |
| abstract_inverted_index.percent | 195 |
| abstract_inverted_index.period, | 64 |
| abstract_inverted_index.receive | 185 |
| abstract_inverted_index.reduced | 24 |
| abstract_inverted_index.(defined | 104, 121, 141 |
| abstract_inverted_index.Abstract | 0 |
| abstract_inverted_index.absolute | 123, 143 |
| abstract_inverted_index.balanced | 247 |
| abstract_inverted_index.baseline | 25, 37, 113, 220 |
| abstract_inverted_index.benefits | 241 |
| abstract_inverted_index.compared | 179 |
| abstract_inverted_index.ejection | 28 |
| abstract_inverted_index.fraction | 29 |
| abstract_inverted_index.function | 9 |
| abstract_inverted_index.historic | 13 |
| abstract_inverted_index.increase | 107, 125, 145 |
| abstract_inverted_index.months). | 61 |
| abstract_inverted_index.patients | 16, 32, 77, 138, 167, 197 |
| abstract_inverted_index.received | 169, 199 |
| abstract_inverted_index.baseline) | 134, 155 |
| abstract_inverted_index.beginning | 98 |
| abstract_inverted_index.carefully | 248 |
| abstract_inverted_index.developed | 78 |
| abstract_inverted_index.included. | 44 |
| abstract_inverted_index.including | 173 |
| abstract_inverted_index.occurred, | 225 |
| abstract_inverted_index.patients, | 73, 118 |
| abstract_inverted_index.patients. | 159 |
| abstract_inverted_index.44%‐48%) | 52 |
| abstract_inverted_index.Likelihood | 160 |
| abstract_inverted_index.metastatic | 19 |
| abstract_inverted_index.reversible | 103, 120, 231 |
| abstract_inverted_index.vulnerable | 251 |
| abstract_inverted_index.compromised | 219 |
| abstract_inverted_index.follow‐up | 55, 212 |
| abstract_inverted_index.inhibitors, | 178 |
| abstract_inverted_index.medications | 171 |
| abstract_inverted_index.numerically | 164 |
| abstract_inverted_index.population. | 252 |
| abstract_inverted_index.trastuzumab | 6, 200, 243 |
| abstract_inverted_index.ventricular | 27 |
| abstract_inverted_index.Sixty‐five | 194 |
| abstract_inverted_index.investigated | 2 |
| abstract_inverted_index.irreversible | 140 |
| abstract_inverted_index.real‐world | 12 |
| abstract_inverted_index.trastuzumab. | 99 |
| abstract_inverted_index.two‐thirds | 235 |
| abstract_inverted_index.reversibility | 162 |
| abstract_inverted_index.(interquartile | 49 |
| abstract_inverted_index.Thirty‐seven | 31 |
| abstract_inverted_index.cardiotoxicity | 80, 90, 101, 208, 224 |
| abstract_inverted_index.>5%‐points | 132, 153 |
| abstract_inverted_index.<5%‐points | 111 |
| abstract_inverted_index.HER2‐positive | 18, 34, 202 |
| abstract_inverted_index.beta‐blockers | 175 |
| abstract_inverted_index.≥10%‐points | 126 |
| abstract_inverted_index.<10%‐points | 146 |
| abstract_inverted_index.angiotensine‐2 | 177 |
| abstract_inverted_index.ACE‐inhibitors, | 174 |
| abstract_inverted_index.cardio‐protective | 170 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5034350317 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 14 |
| corresponding_institution_ids | https://openalex.org/I4210091119 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.8199999928474426 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.7380003 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |