Cyclophosphamide/doxorubicin/trastuzumab

Cyclophosphamide/doxorubicin/trastuzumab Reactions 1704, p124 - 2 Jun 2018 Cyclophosphamide/doxorubicin/ trastuzumab Irreversible left atrium dilatation, left ventricular dysfunction and atrial fibrillation with rapid ventricular response: case report A woman [exact age at the time of reaction onset not clearly stated] developed irreversible left atrium dilatation, atrial fibrillation with rapid ventricular response and left ventricular dysfunction following treatment with trastuzumab, cyclophosphamide and doxorubicin [dosages and routes not stated; not all durations of treatments to reactions onsets and outcomes stated]. The woman was diagnosed with stage IV invasive ductal left breast cancer in 2002 (at the age of 52 years) with bone metastases. Following left-modified radical mastectomy, she received treatment with six cycles of doxorubicin followed by adjuvant CMF regimen that consisted cyclophosphamide, concurrently with methotrexate and fluorouracil. In November 2008, due to disease progression, she received treatment with trastuzumab plus docetaxel combination therapy. No heart disease was observed at baseline. However, after 22 months of trastuzumab initiation, the left atrial volume index (LAVI) was found to be increased, but the left ventricular function was preserved. She presented with the symptoms of fatigue, palpitation and exertional dyspnoea after six months. Electrocardiography findings led to the diagnosis of atrial fibrillation with rapid ventricular response. On echocardiography, the left ventricular function was found to be decreased from 58% to 45% along with further dilatation of the atrium. The woman’s treatment with trastuzumab was discontinued. She was treated with bisoprolol, which controlled the arrhythmia and warfarin therapy was initiated. Normal sinus rhythm was restored following electrical cardioversion, but recurrence of the arrhythmia occurred. Thereafter, bisoprolol therapy was continued. Five months following the withdrawal of trastuzumab, LV function normalised and returned to the baseline, but LAVI increase was persistent. Due to the disease progression, she was treated with lapatinib. In September 2014, metastatic progression occurred. Her LVEF was normal. She had achieved cardiovascular haemodynamic stability with medical therapy. Trastuzumab was re-initiated. Seven months following the re- initiation, left atrium volume showed a further increase, while the LVEF measured 70%. Despite these findings, trastuzumab therapy was continued without any evidence of left ventricular failure. Author comment: "[A]dverse effects of [trastuzumab], including cardiotoxicity, have been observed in these patients. The incidence of cardiac adverse events associated with the isolated use of [trastuzumab] ranges from 2% to 4%, and it may increase up to 16% with previous use of anthracyclines and/or cyclophosphamide." Dolci G, et al. Irreversible left atrium dilatation preceding left ventricular dysfunction during trastuzumab therapy. Minerva Cardioangiologica 66: 223-224, No. 2, Apr 2018. Available from: URL: http://doi.org/10.23736/ S0026-4725.17.04483-8 - Italy 803323109 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Cyclophosphamide/doxorubicin/trastuzumab

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
Free
1 page
Loading next page...
1 Page
 
/lp/springer_journal/cyclophosphamide-doxorubicin-trastuzumab-6i9yTxgLKP
Publisher
Springer International Publishing
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46767-4
Publisher site
See Article on Publisher Site

Abstract

Reactions 1704, p124 - 2 Jun 2018 Cyclophosphamide/doxorubicin/ trastuzumab Irreversible left atrium dilatation, left ventricular dysfunction and atrial fibrillation with rapid ventricular response: case report A woman [exact age at the time of reaction onset not clearly stated] developed irreversible left atrium dilatation, atrial fibrillation with rapid ventricular response and left ventricular dysfunction following treatment with trastuzumab, cyclophosphamide and doxorubicin [dosages and routes not stated; not all durations of treatments to reactions onsets and outcomes stated]. The woman was diagnosed with stage IV invasive ductal left breast cancer in 2002 (at the age of 52 years) with bone metastases. Following left-modified radical mastectomy, she received treatment with six cycles of doxorubicin followed by adjuvant CMF regimen that consisted cyclophosphamide, concurrently with methotrexate and fluorouracil. In November 2008, due to disease progression, she received treatment with trastuzumab plus docetaxel combination therapy. No heart disease was observed at baseline. However, after 22 months of trastuzumab initiation, the left atrial volume index (LAVI) was found to be increased, but the left ventricular function was preserved. She presented with the symptoms of fatigue, palpitation and exertional dyspnoea after six months. Electrocardiography findings led to the diagnosis of atrial fibrillation with rapid ventricular response. On echocardiography, the left ventricular function was found to be decreased from 58% to 45% along with further dilatation of the atrium. The woman’s treatment with trastuzumab was discontinued. She was treated with bisoprolol, which controlled the arrhythmia and warfarin therapy was initiated. Normal sinus rhythm was restored following electrical cardioversion, but recurrence of the arrhythmia occurred. Thereafter, bisoprolol therapy was continued. Five months following the withdrawal of trastuzumab, LV function normalised and returned to the baseline, but LAVI increase was persistent. Due to the disease progression, she was treated with lapatinib. In September 2014, metastatic progression occurred. Her LVEF was normal. She had achieved cardiovascular haemodynamic stability with medical therapy. Trastuzumab was re-initiated. Seven months following the re- initiation, left atrium volume showed a further increase, while the LVEF measured 70%. Despite these findings, trastuzumab therapy was continued without any evidence of left ventricular failure. Author comment: "[A]dverse effects of [trastuzumab], including cardiotoxicity, have been observed in these patients. The incidence of cardiac adverse events associated with the isolated use of [trastuzumab] ranges from 2% to 4%, and it may increase up to 16% with previous use of anthracyclines and/or cyclophosphamide." Dolci G, et al. Irreversible left atrium dilatation preceding left ventricular dysfunction during trastuzumab therapy. Minerva Cardioangiologica 66: 223-224, No. 2, Apr 2018. Available from: URL: http://doi.org/10.23736/ S0026-4725.17.04483-8 - Italy 803323109 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off