Učinci primjene trastuzumaba i trastuzumab-emtansina na QTc interval.

Effects of trastuzumab and trastuzumab-emtansine on QTc intervals.

Introduction: Trastuzumab and trastuzumab-emtansine are antibody drugs and antibody-conjugate for human epidermal growth factor receptor 2 (HER2)- positive breast cancer. Their possible side effects can be QT prolongation and reduction of left ventricular ejection fraction (LVEF), as previously documented.1-3 Methods and Results: All patients were previously treated with standard regimen: paclitaxel and cisplatinum. After that they received specific antibody drugs. The aim of this study was to test their effect on QTc interval in our patients. A total of 26 patients with preserved LVEF were treated with trastuzumab and before every application, ECG was obtained and analyzed. Later on, 24 patients (aged 57.33 years; 46-69 years) continued the treatment with trastuzumab-emtansine because of metastatic disease. Due to reduction of LVEF two patients could not continue with therapy. The last ECG was obtained 6 months after the last drug application. Statistical analysis was performed using standard t-test. Significant QTc prolongation was noticed after the third application of both drugs, continued during the fourth, fifth and sixth application of both drugs and normalization was noticed after six months without therapy. Results are shown in tables 1, 2 and 3. Conclusion: Treatment with trastuzumab and also with trastuzumab-emtansine significantly prolonged QTc interval in patients with breast cancer, but the change was reversible after the cessation of treatment. [ABSTRACT FROM AUTHOR]

Uvod: Trastuzumab i trastuzumab-emtansin su lijekovi, tj. antitijela, odnosno konjugat antitijela i emtansina za humani epidermalni faktor rasta receptora 2 (HER2) - pozitivni karcinom dojke. Njihove moguće nuspojave mogu biti produljenje QT i smanjenje ejekcijske frakcije lijevog ventrikula (LVEF), kao što je prethodno opisano u literaturi.1-3 Metode i rezultati: Sve prikazane bolesnice su prethodno liječene početnom standardnom kombinacijom paklitaksela i karboplatine. Nakon toga dobile su trastuzumab, pa trastuzumab-emtansin. Cilj ove studije bio je ispitati njihov učinak na QTc interva. Ukupno 26 bolesnica s očuvanom LVEF liječeno je trastuzumabom i prije svake primjene lijeka sniman je i analiziran EKG. 24 bolesnice (prosječne dobi 57,33 godine; 46-69 godina) su nastavile liječenje trastuzumab-emtansinom zbog metastatske bolesti. Dvije su bolesnice zbog pada LVEF-a obustavile liječenje. Posljednji EKG je snimljen 6 mjeseci nakon posljednje doze lijeka. Značajno produljenje QTc intervala primijećeno je nakon treće primjene oba lijeka, nastavljeno je tijekom četvrte, pete i šeste primjene oba lijeka, a normalizacija QTc intervala primijećena je nakon šest mjeseci bez terapije. Rezultati su prikazani u tablicama 1, 2 i 3. Zaključak: Liječenje trastuzumabom i trastuzumabemtansinom značajno produžuje QTc interval u bolesnica s HER2 pozitivnim karcinomom dojke, ali je taj učinak bio reverzibilan. [ABSTRACT FROM AUTHOR]

Copyright of Cardiologia Croatica is the property of Croatian Cardiac Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)