Researchers affiliated with the NSABP B-31 study have reported that the adjuvant administration of sequential Adriamycin® (doxorubicin)-Cytoxan®  (cyclophosphamide) followed by Taxol® (paclitaxel) and Herceptin® (trastuzumab) for 52 weeks increases the incidence of congestive heart failure compared to AC-T alone. The details of this study were presented at the 2007 meeting of the American Society of Clinical Oncology (ASCO) in June.

Herceptin has been shown to improve disease-free and overall survival among women with HER2-positive breast cancer.[1] In the ASCO update (combined NCCTG N9831 and NSABP-31 studies) disease-free 4 year survival was 85.9% in the Herceptin group compared to 73.1% in the control group. Overall 4 year survival was 92.6% in the Herceptin group compared to 89.4% in the control group.

• Updated results of cardiac complications associated with adjuvant Herceptin were presented at ASCO.[2] Study participants have now been followed for five years.
• Heart problems occurred in 3.8 % of women treated with chemotherapy and Herceptin and 0.9 % of women treated with chemotherapy alone.

A higher risk of Herceptin-related heart problems was reported among older women, women taking high blood pressure medications, and women with worse heart function at the start of the study. Heart problems generally improved after Herceptin was discontinued.

Comments: These results are reassuring in that they indicate that the previously-reported risk of Herceptin-related heart problems has not increased with additional follow-up.

References:

[2]Rastogi P, Jeong J, Geyer CE et al. Five-year update of cardiac dysfunction on NSABP B-31, a randomized trial of sequential doxorubicin/cyclophosphamide (AC)→paclitaxel (T) compared to AC→T with trastuzumab (H). Proceedings of the 43rd Annual Meeting of the American Society of Clinical Oncology. Chicago, IL.  2007. Abstract # LBA513.

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