Breast Cancer Drug Linked To Heart Problems

By: Pat Prescott
Published: Aug 11, 2021

A study has found that the breast cancer drug, Trastuzumab (Herceptin) is linked to heart problems in elderly women. The first study to investigate the effect the drug has on heart and vascular function in elderly patients has found that it increases the risk of heart problems, particularly in women with a history of heart disease, diabetes or both. Authors of the study, published in the cancer journal, Annals of Oncology, looked at records for 45 women aged between 70 and 92 who had been treated with trastuzumab since 2005 and found that 26.7% (12) of the patients developed heart problems caused by the drug.

The findings highlight the need to study cancer drugs in older patients; most clinical trials for breast cancer drugs involve younger women who have fewer health problems along with their cancer, the researchers said. “Approximately 70 percent of all newly diagnosed cancers occur in patients older than 65,” and the number of patients of this age range is likely to increase in the coming decades as the population ages, said study researcher Dr. César Serrano, who carried out the research while working at the Vall d’Hebron University Hospital in Barcelona. We think that it is reasonable to refer elderly breast cancer patients to a cardiologist if one or more cardiovascular risk factors are present before or during treatment with trastuzumab. Moreover, a closer surveillance of early symptoms and cardiac function is highly recommended,” Serrano said.

The heart problems seen in the study included congestive heart failure and a drop in the volume of blood pumped out by the heart with each beat. When the women stopped taking the drug, all but one of the women recovered fully, and five of them were healthy enough to restart the treatment. Herceptin is the current standard drug given to women with the type of breast cancer that expresses the protein HER2 on the surface of the cancer cells (called HER2 positive breast cancer).

However the risk factors may out weight the alternative. The original studies of trastuzumab showed that it improved survival in late-stage (metastatic) breast cancer, but there is controversy over whether trastuzumab is effective in earlier stage cancer. Trastuzumab is also controversial because of its cost, as much as $100,000 per year, and while certain private insurance companies in the U.S. and government health care systems in Canada, the U.K. and elsewhere have refused to pay for trastuzumab for certain patients. Some companies have since accepted trastuzumab treatment as a covered preventative treatment.

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