5. Incidence of herceptin induced cardiomyopathy in treated breast cancer patients: A prospective single center study in Saudi Arabia

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Clinical Research. Digital Poster. Herceptin therapy is currently a standard therapy for receptor positive breast cancer. Prior studies suggested that Herceptin reduced risk of breast cancer recurrence. Nevertheless, cardiotoxicity is a well-known adverse effect of cancer related therapies. Early identification of patients at risk for cardiotoxicity could prevent late cardiovascular complications. In Saudi Arabia, there is limited published data about Herceptin cardiotoxicity. Thus, the aim of this study is to estimate the incidence of Herceptin induced cardiomyopathy in a prospective well controlled manner. This is a prospective study conducted at king abdulaziz medial city between January 2012 and December 2013. The study included all patients who had proven breast cancer and were eligible for Herceptin therapy. Patients with prior cardiovascular diseases or pregnant patients were excluded. Herceptin therapy was administered according to standard guideline for management. Patients were followed up for one year: clinically every three weeks in the first three month then every three months for one year. Furthermore, Echocardiography and troponin evaluation were obtained every three months, and cardiac magnetic resonance scanning every 6 months. A total of 50 patients (mean age 47 ± 10 years, 96% were Saudis) without previous cardiovascular diseases were included. Using echocardiography criteria, 4(8%) patients developed cardiomyopathy. During follow-up, 75% of them had a persistent low left ventricular ejection fraction (LVEF) less than 50%, while only one patient recovered her LVEF. Global longitudinal strain (GLS) was done in 45 patients, one third had normal GLS (<−18). On the other hand, using CMR, only one patient had a significant dropped in the LVEF (from 61% to 48%) while another patient developed new myocardial delayed enhancement. Conclusion Our study showed low incidence rate of cardiomyopathy toxicity due to Herceptin therapy in Saudi individuals. However, the rate of cardiomyopathy differs by the criteria used as well as the imaging modality used to assess LV function.