Good News About Herceptin and Hearts

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

NOVEMBER 21, 2017

Most women with breast cancer are aware of the "miracle" drug Herceptin/Trastuzumab. Used in the treatment of women who have her2 positive breast cancers, it has made an incredible positive difference in their health. In 2010, the results of four important clinical trials were announced and found that one year of Herceptin plus standard adjuvant therapy significantly reduced the risk of disease recurrence and extended overall survival. At the ASCO meeting where these results were shared, the room erupted with a standing ovation--not a typical medical conference experience. 

This has also long been an important drug in the care of women who have her2 positive metastatic breast cancer. One concern, in both settings, has been the risk of cardiac damage associated with the drug. Cardiac function is carefully monitored for women receiving herceptin (or its' close cousins), and sometimes women have needed to take treatment breaks. 

Just reported in the Journal of Clinical Oncology is the very good news that no longterm damage is done. Here is the start of a report from Medpage and a link to read more:

No Long-Term Cardiac Toxicity With Trastuzumab

— Reassurance for patients with HER2-positive breast cancer

by Kristin Jenkins

Adding trastuzumab (Herceptin) to adjuvant chemotherapy didn't cause long-term deterioration of cardiac function, cardiac symptoms, or health-related quality of life (QoL) in women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, a study showed. Five (4.5%) of 110 women in the control group and 10 (3.4%) in the trastuzumab group had a more than 10% decline in left ventricular ejection fraction (LVEF) from baseline to a value less than 50% in the Protocol B-31 long-term cardiac follow-up study of women from the National Surgical Adjuvant Breast and Bowel Project (NSABP). Fully 95.3% of the 297 patients with no underlying cardiac disease at baseline randomly assigned to receive trastuzumab had LVEF of at least 50% after a median of 8.8 years. Only two (0.6%) patients in the trastuzumab group had LVEF ≤40%, Patricia Ganz, MD, of the University of California Los Angeles and colleagues reported online in the Journal of Clinical Oncology.

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