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Original Articles
- Early Decline in Left Ventricular Ejection Fraction Can Predict Trastuzumab-Related Cardiotoxicity in Patients with Breast Cancer: A Study Using 13 Years of Registry Data
- Eun Kyoung Kim, Jinhyun Cho, Ji-Yeon Kim, Sung-A Chang, Sung-Ji Park, Jin Oh Choi, Sang Chol Lee, Jin Seok Ahn, Seung Woo Park, Young-Hyuck Im, Eun Seok Jeon, Yeon Hee Park
- Cancer Res Treat. 2019;51(2):727-736. Published online September 4, 2018
- DOI: https://doi.org/10.4143/crt.2018.262
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Abstract
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ePub - Purpose
While concerns regarding trastuzumab-related cardiac dysfunction (TRCD) in patients with breast cancer are increasing, there is a lack of evidence supporting the current recommendations for TRCD monitoring. We aimed to investigate the clinical predictors of TRCD in the adjuvant setting of human epidermal growth factor receptor 2–positive breast cancer patients.
Materials and Methods
From August 2003 to April 2016, consecutive 998 patients who were treated with adjuvant trastuzumab for breast cancer were retrospectively evaluated. TRCD was defined as a decrease ≥10% in left ventricular ejection fraction (LVEF), with a decline below the normal limit or symptomatic heart failure.
Results
Among 787 eligible patients who had complete data sets consisting of both baseline and follow-up assessment of left ventricular systolic function by echocardiography (mean age, 49.9±9.5 years), 58 (7.4%) developed TRCD. TRCD patients had lower baseline LVEF (63% [59–66] vs. 65% [61–68], p=0.016) and more frequently administered Adriamycin (98% vs. 89%, p=0.022) than those without TRCD. On follow-up echocardiography, a drop in LVEF ≥5% within the first 3 months was more frequent in TRCD patients (78.3% vs. 38.4%, p<0.001). Regardless of baseline LVEF and Adriamycin treatment, a drop in LVEF ≥5% within the first 3 months of trastuzumab administration was strongly associated with the development of TRCD (adjusted hazard ratio, 45.1[17.0–127.6], p<0.001).
Conclusion
The overall incidence of TRCD was 7.4% in Asian breast cancer patients treated with adjuvant trastuzumab. A decline in LVEF ≥5% within the first 3 months of trastuzumab initiation was strongly associated with TRCD development in patients with breast cancer. -
Citations
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- Noninvasive identification and therapeutic implications of supernormal left ventricular contractile phenotype
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- Clinical Features of Neuroendocrine Lung Cancer
- Eun Kyoung Kim, Geun Doo Jang, Cheol Won Suh, Sang We Kim, Sang Do Lee, Woo Seong Kim, Jung Shin Lee, Ho Jung Lee, In Cheol Lee
- Cancer Res Treat. 2001;33(6):474-477. Published online December 31, 2001
- DOI: https://doi.org/10.4143/crt.2001.33.6.474
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Abstract
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- PURPOSE
This study was performed to investigate the clinical features of neuroendocrine lung cancer.
MATERIALS AND METHODS
We performed a retrospective review of the histopathology and clinical information of 21 patients diagnosed as having neuroendocrine lung cancer between 1995 and 1999.
RESULTS
Nineteen cases were male and 2 were female. The median age was 64 years (range: 45~80). Pathologic classification were atypical carcinoid (AC) in 2 cases, large cell neuroendocrine carcinoma (LCNEC) in 7 cases, and intermediate cell neuroendocrine carcinoma (ICNC) in 12 cases. Nine patients received tumor resection as first line therapy; adjuvant chemotherapy was given to 3 patients. Concurrent chemoradiotherapy was given to 1 patient. Six patients received palliative chemotherapy. The chemotherapy regimen included etoposide cisplatin in 5 cases and vinorelbine+cisplatin in 1 case. The median survival times were 11, 16 and 59 weeks for AC, LCNEC and ICNC, respectively. The estimated 2-year survival rates were AC 0%, LCNEC 22% and ICNC 31%.
CONCLUSION
Surgery may have a positive effect on survival in patients with early stage cansers. Further investigation is required to improve survival in cases of advanced stage cancer.
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