Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia

Background: HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management. Method: This retros...

Full description

Saved in:
Bibliographic Details
Main Authors: Alaa Shahbar, Abdullah A Alhifany, Yasser M Alatawi, Mohammed Alnuhait, Abdullah Alshammari, Majed Alshamrani, Abdulhalim Kinsara, Atif AlQubbany, Mahasen Alharbi, Abdelmajid Alnatsheh, Meteb Alfoheidi
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Clinical Medicine Insights: Oncology
Online Access:https://doi.org/10.1177/11795549241297881
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850124256616120320
author Alaa Shahbar
Abdullah A Alhifany
Yasser M Alatawi
Mohammed Alnuhait
Abdullah Alshammari
Majed Alshamrani
Abdulhalim Kinsara
Atif AlQubbany
Mahasen Alharbi
Abdelmajid Alnatsheh
Meteb Alfoheidi
author_facet Alaa Shahbar
Abdullah A Alhifany
Yasser M Alatawi
Mohammed Alnuhait
Abdullah Alshammari
Majed Alshamrani
Abdulhalim Kinsara
Atif AlQubbany
Mahasen Alharbi
Abdelmajid Alnatsheh
Meteb Alfoheidi
author_sort Alaa Shahbar
collection DOAJ
description Background: HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management. Method: This retrospective study included HER2-positive breast cancer patients aged 18 or older who received at least 1 dose of HER2-targeting treatment between 2016 and 2020. The primary endpoint was the incidence of cardiotoxicity, defined as LVEF <50% with a 10% decline, LVEF drop by >15%, or onset of symptomatic heart failure. Secondary endpoints included the proportion of patients with baseline LVEF 50% to 55% developing cardiotoxicity, those discontinuing HER2 therapy due to heart failure, those treated with heart failure medications, and those continuing HER2 therapy while on heart failure medications. Another secondary outcome was the development of a hospital protocol for monitoring cardiotoxicity in these patients. Results: A total of 212 patients were included, with a median age of 56.5 years (interquartile range: 43-58 years). Twenty-two patients (10.37%) experienced cardiotoxicity from HER2-targeted treatment. Thirteen patients (6.13%) had asymptomatic heart failure with LVEF decrease of more than 10% to less than 50%. Five patients (2.35%) with LVEF less than 40% had asymptomatic heart failure, while 4 patients (1.88%) had symptomatic heart failure regardless of LVEF decline. HER2-targeted treatment was temporarily discontinued in 3 (13.63%) patients and permanently in 4 (18.18%) patients due to cardiotoxicity. The remaining 15 patients resumed treatment without interruption. Only 13 out of 22 patients were referred to cardiologists and prescribed heart failure medications. Conclusion: Close monitoring of LVEF in patients receiving HER2-targeting therapy can help health care providers initiate anti-heart failure medications to prevent LVEF deterioration and maintain HER2-targeting therapy.
format Article
id doaj-art-7bf42f8ecd4346dd9706b0c998933a33
institution OA Journals
issn 1179-5549
language English
publishDate 2024-11-01
publisher SAGE Publishing
record_format Article
series Clinical Medicine Insights: Oncology
spelling doaj-art-7bf42f8ecd4346dd9706b0c998933a332025-08-20T02:34:20ZengSAGE PublishingClinical Medicine Insights: Oncology1179-55492024-11-011810.1177/11795549241297881Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi ArabiaAlaa Shahbar0Abdullah A Alhifany1Yasser M Alatawi2Mohammed Alnuhait3Abdullah Alshammari4Majed Alshamrani5Abdulhalim Kinsara6Atif AlQubbany7Mahasen Alharbi8Abdelmajid Alnatsheh9Meteb Alfoheidi10Pharmacy Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaPharmacy Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaDepartment of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi ArabiaPharmacy Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaPharmacy Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi ArabiaPharmaceutical Care Department, King Abdul-Aziz Medical City, Jeddah, Saudi ArabiaCardiovascular Diseases Department, King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaCardiovascular Diseases Department, King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaPharmaceutical Care Department, King Abdul-Aziz Medical City, Jeddah, Saudi ArabiaPharmaceutical Care Department, King Abdul-Aziz Medical City, Jeddah, Saudi ArabiaDepartment of Oncology, Ministry of National Guard Health Affairs, Jeddah, Saudi ArabiaBackground: HER2-targeting therapies may increase the risk of decreased left ventricular ejection fraction (LVEF), potentially leading to heart failure. The growing number of breast cancer survivors due to HER2-targeted treatments necessitates long-term cardiotoxicity management. Method: This retrospective study included HER2-positive breast cancer patients aged 18 or older who received at least 1 dose of HER2-targeting treatment between 2016 and 2020. The primary endpoint was the incidence of cardiotoxicity, defined as LVEF <50% with a 10% decline, LVEF drop by >15%, or onset of symptomatic heart failure. Secondary endpoints included the proportion of patients with baseline LVEF 50% to 55% developing cardiotoxicity, those discontinuing HER2 therapy due to heart failure, those treated with heart failure medications, and those continuing HER2 therapy while on heart failure medications. Another secondary outcome was the development of a hospital protocol for monitoring cardiotoxicity in these patients. Results: A total of 212 patients were included, with a median age of 56.5 years (interquartile range: 43-58 years). Twenty-two patients (10.37%) experienced cardiotoxicity from HER2-targeted treatment. Thirteen patients (6.13%) had asymptomatic heart failure with LVEF decrease of more than 10% to less than 50%. Five patients (2.35%) with LVEF less than 40% had asymptomatic heart failure, while 4 patients (1.88%) had symptomatic heart failure regardless of LVEF decline. HER2-targeted treatment was temporarily discontinued in 3 (13.63%) patients and permanently in 4 (18.18%) patients due to cardiotoxicity. The remaining 15 patients resumed treatment without interruption. Only 13 out of 22 patients were referred to cardiologists and prescribed heart failure medications. Conclusion: Close monitoring of LVEF in patients receiving HER2-targeting therapy can help health care providers initiate anti-heart failure medications to prevent LVEF deterioration and maintain HER2-targeting therapy.https://doi.org/10.1177/11795549241297881
spellingShingle Alaa Shahbar
Abdullah A Alhifany
Yasser M Alatawi
Mohammed Alnuhait
Abdullah Alshammari
Majed Alshamrani
Abdulhalim Kinsara
Atif AlQubbany
Mahasen Alharbi
Abdelmajid Alnatsheh
Meteb Alfoheidi
Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
Clinical Medicine Insights: Oncology
title Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
title_full Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
title_fullStr Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
title_full_unstemmed Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
title_short Assessment of Cardiotoxicity Incidence in Patients Receiving HER-2-Targeted Therapies for Breast Cancer in Saudi Arabia
title_sort assessment of cardiotoxicity incidence in patients receiving her 2 targeted therapies for breast cancer in saudi arabia
url https://doi.org/10.1177/11795549241297881
work_keys_str_mv AT alaashahbar assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT abdullahaalhifany assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT yassermalatawi assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT mohammedalnuhait assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT abdullahalshammari assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT majedalshamrani assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT abdulhalimkinsara assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT atifalqubbany assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT mahasenalharbi assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT abdelmajidalnatsheh assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia
AT metebalfoheidi assessmentofcardiotoxicityincidenceinpatientsreceivingher2targetedtherapiesforbreastcancerinsaudiarabia