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Cardiac monitoring of the administration of trastuzumab at the Portuguese Institute of Oncology of Coimbra Francisco Gentil, EPE
  1. R. Lopes,
  2. A. Silva,
  3. M. Costa,
  4. C. Baeta,
  5. C. Varela
  1. 1Portuguese Institute of Oncology of Coimbra Francisco Gentil EPE (IPOCFG EPE), Pharmacy Department, Coimbra, Portugal
  2. 2Portuguese Institute of Oncology of Coimbra Francisco Gentil EPE (IPOCFG EPE), 2Nuclear Medicine Department, Coimbra, Portugal

Abstract

Background Cardiotoxicity is a recognised adverse effect of trastuzumab. Cumulative doses of chemotherapy (CT) with anthracycline, low left ventricular ejection fraction (LVEF), old age, high body mass index, constitute risk factors to consider. Measurement of LVEF by radionuclide angiography (MUGA) or echocardiogram must be carried out.

Purpose Aim of this retrospective study was to define the tolerability and safety of patients with breast carcinoma treated with trastuzumab at the IPOCFG, EPE, according to the recommendations of The National Cancer Research Institute.

Materials and methods Patients treated with trastuzumab at the Day Hospital (DH), between January 2009 and August 2011. Data collected using the computer application Oncofarm® and SIGEHP®.

Results A total of 253 patients, 96.8% breast carcinoma and 3.2% inflammatory breast carcinoma; 52.2% left breast, 43.1% right breast and 4.7% both; average age: 55 years (28-79); average weight: 68 kg (42-110). Total mastectomy: 44.3%; conservative surgery: 55.7%. Average treatment time: 328 days (1-2806). Treatment was palliative in 62.4% of patients, adjuvant in 33.6% and neoadjuvant in 4%. Previous CT regimens: FEC (57.7%), Docetaxel (31.2%) and Docetaxel/Epirubicin (29.2%). Hormonal therapy prescribed to 10.7% of patients; 52.2% held radiotherapy; 28.5% hypertension controlled with medication; 485 values obtained by MUGA: 17.9% of LVEF were < 55%, of which 27.6% were ≤50%.

Conclusions The trastuzumab is, nevertheless, well tolerated. The main recommendations of The National Cancer Research Institute include: monitoring scheme that defines baseline and heart function during treatment; intervention strategies with cardiovascular therapeutic; simplified rules for start, stop and discontinue trastuzumab; and multidisciplinary approach to the treatment.

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