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Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients: a multicenter cohort study

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Abstract

Background

For targeting anti-HER-2, trastuzumab-incorporated chemotherapy is the standard for HER-2-overexpressing breast cancer in adjuvant settings. But there are few data on trastuzumab in elderly patients. We evaluated the incidence of adverse events among an elderly population of trastuzumab-treated HER-2-positive breast cancer patients in adjuvant settings.

Methods

Data on 39 elderly HER-2 overexpressing breast cancer patients treated with both curative surgery and adjuvant trastuzumab were retrospectively collected from a Japanese multicenter study. The loading dose was 8 mg/kg body weight, and the maintenance dose was 6 mg/kg every 3 weeks; or the loading dose was 4 mg/kg followed by 2 mg/kg weekly as maintenance.

Results

After a median follow-up of 20.0 (2.4–53.9) months, a total of 32 patients (82.1%) completed 1-year trastuzumab treatment. The median treatment duration was 12.0 months (range 2–12; mean 10.5). Adverse events occurred in 11 patients (28.2%). Four (10.2%) discontinued or interrupted treatment after experiencing toxicity. One patient died because of interstitial pneumonia. Three patients (7.7%) had congestive heart failure (CHF), one of whom had a history of angina. Three patients (7.7%) had a lower left ventricular ejection fraction (LVEF), and brain natriuretic peptide elevation was totally observed in three patients (7.7%). Three patients with lower LVEF had received chemotherapy containing doxorubicin before trastuzumab. Of the three patients, two discontinued therapy because of CHF, but all recovered with proper medication containing a diuretic agent.

Conclusions

Elderly patients tolerated trastuzumab well, although careful management is needed.

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Acknowledgments

This study was presented in part at the 18th annual meeting of the Japanese Breast Cancer Society on 24–25 June 2010 in Sapporo, Japan. This study was conducted by the executive committee of the National Surgical Adjuvant Study of Breast Cancer 07, which was supported by the Comprehensive Support Project for Oncology Research of the Public Health Research Foundation, Japan. We would also like to thank Mrs. Naomi Ushiyama for this publication.

Conflict of interest

The authors state that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Clinical Oncology and Chemotherapy, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Masataka Sawaki

  2. Department of Oncology and Hematology, National Cancer Center Hospital East, Chiba, Japan

    Hirofumi Mukai

  3. Department of Medical Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan

    Nahomi Tokudome

  4. Department of Breast and Endocrine Surgery, Osaka University Hospital, Osaka, Japan

    Takahiro Nakayama

  5. Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan

    Naruto Taira

  6. Department of Medical Oncology, Mie University Hospital, Tsu, Japan

    Toshiro Mizuno

  7. Department of Breast and Endocrine Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Yutaka Yamamoto

  8. Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan

    Akiyo Horio

  9. Department of Medicine, Hamamatsu Oncology Center, Hamamatsu, Shizuoka, Japan

    Toru Watanabe

  10. Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan

    Yukari Uemura & Yasuo Ohashi

Authors
  1. Masataka Sawaki
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  2. Hirofumi Mukai
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  3. Nahomi Tokudome
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  11. Yasuo Ohashi
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Corresponding author

Correspondence to Masataka Sawaki.

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Sawaki, M., Mukai, H., Tokudome, N. et al. Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients: a multicenter cohort study. Breast Cancer 19, 253–258 (2012). https://doi.org/10.1007/s12282-011-0270-9

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  • DOI: https://doi.org/10.1007/s12282-011-0270-9

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