دورية أكاديمية
أعرض في EDS

Treatment with Beta-Blockers and ACE-Inhibitors in Breast Cancer Patients Receiving Adjuvant Trastuzumab-Based Therapy and Developing Mild Cardiac Toxicity: A Prospective Study.

التفاصيل البيبلوغرافية
العنوان: Treatment with Beta-Blockers and ACE-Inhibitors in Breast Cancer Patients Receiving Adjuvant Trastuzumab-Based Therapy and Developing Mild Cardiac Toxicity: A Prospective Study.
المؤلفون: Geuna E; Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Lombardi P; Medical School, University of Turin, 10124 Turin, Italy., Martinello R; Oncologia Medica, Ospedale Cardinal Massaia, 14100 Asti, Italy., Garino D; Medical School, University of Turin, 10124 Turin, Italy., Bonzano A; Cardiology Unit, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Galizia D; Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Nuzzo A; Clinical Research Office, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Berchialla P; Dipartimento di Scienze Cliniche e Biologiche, University of Turin, 10124 Turin, Italy., Becco P; Medical School, University of Turin, 10124 Turin, Italy., Mangioni M; Clinical Laboratory, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Zarlo L; Clinical Laboratory, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy., Montemurro F; Multidisciplinary Oncology Outpatient Clinic, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy.
المصدر: Cancers [Cancers (Basel)] 2020 Jan 31; Vol. 12 (2). Date of Electronic Publication: 2020 Jan 31.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: MDPI Country of Publication: Switzerland NLM ID: 101526829 Publication Model: Electronic Cited Medium: Print ISSN: 2072-6694 (Print) Linking ISSN: 20726694 NLM ISO Abbreviation: Cancers (Basel) Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Basel, Switzerland : MDPI
مستخلص: Background: Angiotensin Converting Enzyme inhibitors (ACEis) and beta-blockers (BB) are suggested to prevent and treat trastuzumab-related cardiac toxicity. We performed a prospective clinical trial in women experiencing mild cardiac toxicity (MCT) while on adjuvant treatment with trastuzumab.
Methods: MCT was defined as an asymptomatic absolute decrease in LVEF of ≥ 10 percentage units to >50%. Treatment consisted of enalapril 2.5 mg bid and carvedilol 3.75 mg bid, which were up-titrated to 10 mg bid for the enalapril and 6,25 mg bid of carvedilol. In patients receiving study drug, the primary study end-point was LVEF recovery, which was defined as a post-trastuzumab LVEF returning to no less than -5 percentage points of the baseline value.
Results: 103 patients were enrolled, 100 started trastuzumab, and 98 completed the planned treatment. Sixteen patients (16%) had MCT and received study drugs until trastuzumab completion. None of these patients achieved a post-trastuzumab LVEF recovery. Nevertheless, treated patients had significantly higher median LVEF recovery from nadir to post-trastuzumab LVEF in (8% points vs. 4% points, respectively, p = 0.004), resulting in no difference in post-treatment LVEF values compared to patients without MCT.
Conclusion: Treatment of MCT with ACEis and BB allows faster LVEF recovery from nadir values and should be further studied in this setting.
Competing Interests: Filippo Montemurro has received speaker’s honoraria from Roche, Novartis, Eli Lilly and Pfizer, advisory board honoraria from Roche and travel grants from Roche. Danilo Galizia has received travel grants from Pfizer, BMS, Merck, Novartis and Roche and speakers' honoraria from BMS. All the other authors do not have significant conflicts of interest to disclose.
References: JAMA Netw Open. 2018 Aug 3;1(4):e181456. (PMID: 30646130)
Cancer Res Treat. 2019 Apr;51(2):727-736. (PMID: 30177584)
Science. 1987 Jan 9;235(4785):177-82. (PMID: 3798106)
J Clin Oncol. 2007 Sep 1;25(25):3859-65. (PMID: 17646669)
Circulation. 2006 Dec 5;114(23):2474-81. (PMID: 17101852)
Eur Heart J. 2016 Sep 21;37(36):2768-2801. (PMID: 27567406)
Eur Heart J. 2016 Jun 1;37(21):1671-80. (PMID: 26903532)
Expert Opin Pharmacother. 2019 Jan;20(1):5-9. (PMID: 30396301)
JAMA Oncol. 2016 Aug 1;2(8):1030-7. (PMID: 27348762)
Breast Cancer Res Treat. 2019 Feb;174(1):187-196. (PMID: 30506110)
J Clin Oncol. 2017 Mar 10;35(8):878-884. (PMID: 28199174)
Breast. 2018 Oct;41:1-7. (PMID: 29913374)
J Clin Oncol. 2017 Mar 10;35(8):870-877. (PMID: 27893331)
J Am Coll Cardiol. 2006 Dec 5;48(11):2258-62. (PMID: 17161256)
Science. 1989 May 12;244(4905):707-12. (PMID: 2470152)
Ann Oncol. 2020 Feb;31(2):171-190. (PMID: 31959335)
J Am Coll Cardiol. 2019 Jun 11;73(22):2859-2868. (PMID: 31171092)
Breast Cancer Res Treat. 2020 Jan;179(1):161-171. (PMID: 31605311)
Curr Opin Oncol. 2019 Jan;31(1):35-42. (PMID: 30325338)
معلومات مُعتمدة: IG 2016, project code 19174 Associazione Italiana per la Ricerca sul Cancro; Cardiorete Rete Oncologica del Piemonte e della Valle d'Aosta; Ricerca Corrente Ministero della Salute
فهرسة مساهمة: Keywords: ACE inhibitors; beta blockers; breast cancer; cardiac toxicity; carvedilol; enalapril; trastuzumab
تواريخ الأحداث: Date Created: 20200207 Latest Revision: 20200928
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC7072182
DOI: 10.3390/cancers12020327
PMID: 32023877
قاعدة البيانات: MEDLINE
الوصف
تدمد:2072-6694
DOI:10.3390/cancers12020327