Long Term Follow-Up of National Surgical Adjuvant Breast and Bowel Project Trial B-31: How Well Can We Predict Cardiac Toxicity With Trastuzumab?
Menée sur 1 830 patientes atteintes d'un cancer du sein HER2+ avec envahissement ganglionnaire et incluses dans l'essai de phase III d'un traitement adjuvant NSABP B-31, cette étude analyse la toxicité cardiaque associée au trastuzumab après 7 ans de suivi
The introduction of adjuvant trastuzumab has dramatically reduced recurrence rates and improved survival among womenwith stage I to III human epidermal growth factor receptor 2 (HER2) –positive breast cancer. Although the majority of trials have evaluated the use of trastuzumab administered sequentially after an anthracycline-based regimen, other regimens have also been evaluated, including the regimen of docetaxel, carboplatin, and trastuzumab (TCH). The motivation for testing a nonanthracycline-based regimen was founded largely on concerns about both short- and long-term cardiotoxicity. Indeed, in the pivotal trial that was conducted in the first-line metastatic setting, 27% of patients receiving concurrent doxorubicin, cyclophosphamide, and trastuzumab developed either symptomatic or asymptomatic cardiac dysfunction, compared with13%of patients who received paclitaxel with trastuzumab...
Journal of Clinical Oncology , éditorial en libre accès, 2012