- 61% of patients who continue to take trastuzumab despite asymptomatic left ventricular ejection fraction (LVEF) decline to
- 13% developed a cardiac event.
Why this matters
- First study to examine cardiac events associated with continuing to take trastuzumab with LVEF decline to
- Findings suggest that continuation in such patients may be a promising approach that warrants more systematic study.
- Retrospective cohort of 60 patients identified from an echocardiogram database.
- Continuation group (n=23) continued trastuzumab with LVEF
- Interruption group (n=37) included patients who stopped trastuzumab until LVEF improved to ≥50% or permanently discontinued treatment.
- Funding: NIH.
- Continuation group:
- 61% had no cardiac events.
- 26% developed worsening LVEF (range, 25%-42%), resulting in trastuzumab discontinuation.
- 13% had a cardiac event (n=1 HF [New York Heart Association class III-IV]; n=2 possible/probable cardiovascular death).
- Interruption group:
- 41% were given trastuzumab after LVEF improved to >50%.
- 57% were not restarted on trastuzumab.
- 3% developed HF but no cardiovascular deaths.
- No difference between groups in LVEF after median follow-up of 633 days (54% in the continuation group vs 56%; P=.29).
- Few patients.
- Single-center study.