Increasing survivors of anthracycline-related cardiomyopathy with breast cancer in trastuzumab era: thirty-one-year trends in a Japanese Community.

IF 4 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Breast Cancer Pub Date : 2024-11-01 Epub Date: 2024-08-13 DOI:10.1007/s12282-024-01623-0

Mitsuhiro Watanabe, Shinya Fujiki, Yuji Okura, Chie Toshikawa, Mayuko Ikarashi, Chizuko Kanbayashi, Koji Kaneko, Akira Kikuchi, Eiko Sakata, Keiichi Tsuchida, Kazuyuki Ozaki, Kazuki Moro, Naoki Kubota, Takeshi Kashimura, Masato Moriyama, Nobuaki Sato, Naohito Tanabe, Yu Koyama, Toshifumi Wakai, Yasuo Saijo, Takayuki Inomata

{"title":"Increasing survivors of anthracycline-related cardiomyopathy with breast cancer in trastuzumab era: thirty-one-year trends in a Japanese Community.","authors":"Mitsuhiro Watanabe, Shinya Fujiki, Yuji Okura, Chie Toshikawa, Mayuko Ikarashi, Chizuko Kanbayashi, Koji Kaneko, Akira Kikuchi, Eiko Sakata, Keiichi Tsuchida, Kazuyuki Ozaki, Kazuki Moro, Naoki Kubota, Takeshi Kashimura, Masato Moriyama, Nobuaki Sato, Naohito Tanabe, Yu Koyama, Toshifumi Wakai, Yasuo Saijo, Takayuki Inomata","doi":"10.1007/s12282-024-01623-0","DOIUrl":null,"url":null,"abstract":"Background: Trastuzumab has improved breast cancer (BC) prognosis and reduced anthracycline use. However, the characteristic changes of anthracycline-related cardiomyopathy (ARCM) in patients with BC remain unclear. We aimed to update our understanding of ARCM in the trastuzumab era.Methods: This retrospective observational cohort study included 2959 patients with BC treated with anthracyclines at three regional cancer centers in Niigata City between 1990 and 2020. Seventy-five patients (2.5%) developed ARCM and were categorized into two groups: pre- 2007 (early phase) and post-2007 (late phase), corresponding to before and during the trastuzumab era in Japan.Results: ARCM incidence peaked at 6% in the 1990s, then decreased and stabilized at 2% until the 2010s. Survivors of anthracycline-treated BC increased more rapidly in the late phase, with four times as many patients with ARCM compared to the end of the early phase (26 and six, respectively). Although the rate of change in accumulation from the early phase to the late phase was slight in the anthracycline-treated BC group, it was more pronounced in the ARCM group (P < 0.001). Mean anthracycline use in the late phase was significantly lower than in the early phase (307 vs. 525 mg/m2, P < 0.001). Five-year survival rates in the late phase tended to be higher than early phase (45% and 28%, respectively. P = 0.058). Human epidermal growth factor receptor type 2 (HER2) positivity with trastuzumab therapy in the late phase was an independent predictor for mortality within 10 years (hazard ratio = 0.24, 95% confidence interval: 0.10-0.56; P = 0.001).Conclusions: HER2-positive patients with ARCM receiving trastuzumab therapy had a better prognosis than HER2-positive and HER2-negative patients with ARCM not receiving trastuzumab therapy, and this trend has been increasing in the trastuzumab era. These findings highlight the importance of HER2-targeted treatments in improving prognosis for BC patients with ARCM.","PeriodicalId":56083,"journal":{"name":"Breast Cancer","volume":" ","pages":"1080-1091"},"PeriodicalIF":4.0000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489246/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12282-024-01623-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/13 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Trastuzumab has improved breast cancer (BC) prognosis and reduced anthracycline use. However, the characteristic changes of anthracycline-related cardiomyopathy (ARCM) in patients with BC remain unclear. We aimed to update our understanding of ARCM in the trastuzumab era.

Methods: This retrospective observational cohort study included 2959 patients with BC treated with anthracyclines at three regional cancer centers in Niigata City between 1990 and 2020. Seventy-five patients (2.5%) developed ARCM and were categorized into two groups: pre- 2007 (early phase) and post-2007 (late phase), corresponding to before and during the trastuzumab era in Japan.

Results: ARCM incidence peaked at 6% in the 1990s, then decreased and stabilized at 2% until the 2010s. Survivors of anthracycline-treated BC increased more rapidly in the late phase, with four times as many patients with ARCM compared to the end of the early phase (26 and six, respectively). Although the rate of change in accumulation from the early phase to the late phase was slight in the anthracycline-treated BC group, it was more pronounced in the ARCM group (P < 0.001). Mean anthracycline use in the late phase was significantly lower than in the early phase (307 vs. 525 mg/m², P < 0.001). Five-year survival rates in the late phase tended to be higher than early phase (45% and 28%, respectively. P = 0.058). Human epidermal growth factor receptor type 2 (HER2) positivity with trastuzumab therapy in the late phase was an independent predictor for mortality within 10 years (hazard ratio = 0.24, 95% confidence interval: 0.10-0.56; P = 0.001).

Conclusions: HER2-positive patients with ARCM receiving trastuzumab therapy had a better prognosis than HER2-positive and HER2-negative patients with ARCM not receiving trastuzumab therapy, and this trend has been increasing in the trastuzumab era. These findings highlight the importance of HER2-targeted treatments in improving prognosis for BC patients with ARCM.

Abstract Image

查看原文本刊更多论文

曲妥珠单抗时代乳腺癌蒽环类相关心肌病存活者的增加：一个日本社区的 31 年趋势。

背景：曲妥珠单抗改善了乳腺癌（BC）的预后并减少了蒽环类药物的使用。然而，蒽环类药物相关心肌病（ARCM）在乳腺癌患者中的特征性变化仍不清楚。我们旨在更新我们对曲妥珠单抗时代蒽环类药物相关心肌病的认识：这项回顾性观察队列研究纳入了 1990 年至 2020 年期间在新潟市三个地区癌症中心接受蒽环类药物治疗的 2959 例 BC 患者。75名患者（2.5%）发生了ARCM，并被分为两组：2007年以前（早期阶段）和2007年以后（晚期阶段），分别对应于日本曲妥珠单抗时代之前和期间：结果：ARCM发病率在20世纪90年代达到6%的峰值，随后下降并稳定在2%，直到2010年代。蒽环类药物治疗 BC 的存活者在晚期增加得更快，与早期末期相比，ARCM 患者人数增加了四倍（分别为 26 人和 6 人）。虽然蒽环类药物治疗的 BC 组从早期到晚期的蓄积变化率很小，但 ARCM 组的变化率更为明显（P 2，P 结论）：接受曲妥珠单抗治疗的HER2阳性ARCM患者的预后优于未接受曲妥珠单抗治疗的HER2阳性和HER2阴性ARCM患者，而且这一趋势在曲妥珠单抗时代不断增强。这些发现凸显了HER2靶向治疗在改善ARCM BC患者预后方面的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Breast Cancer ONCOLOGY-OBSTETRICS & GYNECOLOGY

CiteScore

6.70

自引率

2.50%

发文量

105

审稿时长

6-12 weeks

期刊介绍： Breast Cancer, the official journal of the Japanese Breast Cancer Society, publishes articles that contribute to progress in the field, in basic or translational research and also in clinical research, seeking to develop a new focus and new perspectives for all who are concerned with breast cancer. The journal welcomes all original articles describing clinical and epidemiological studies and laboratory investigations regarding breast cancer and related diseases. The journal will consider five types of articles: editorials, review articles, original articles, case reports, and rapid communications. Although editorials and review articles will principally be solicited by the editors, they can also be submitted for peer review, as in the case of original articles. The journal provides the best of up-to-date information on breast cancer, presenting readers with high-impact, original work focusing on pivotal issues.