Long-term cardiac safety and outcomes of dose-dense doxorubicin and cyclophosphamide followed by paclitaxel and trastuzumab with and without lapatinib in patients with early breast cancer

摘要: BACKGROUND The authors have previously reported 2 consecutive phase trials in patients with early breast cancer that overexpresses human epidermal growth factor receptor (HER2) to assess the feasibility of incorporating anti-HER2 therapies into dose-dense (dd) chemotherapy regimens. The incidence congestive heart failure (CHF) at a median follow-up years was 1.4% and 3.2%, respectively. METHODS In trial A, received dd doxorubicin cyclophosphamide (AC)paclitaxel (T) (each given every weeks) × 4 trastuzumab (H) × 1 year. In B, weekly T (weekly × 12) substituted for ddT lapatinib year added. Herein, report longer-term CHF distant disease-free survival (DDFS). RESULTS From January 2005 May 2008, 165 enrolled (median age, 46 years, left ventricular ejection fraction 68% [range, 52%-81%]), 17%of whom had previous hypertension. With 84 months (trial A) 57 B), 1 additional patient developed CHF. Therefore, cumulative (95% confidence interval [95% CI], 1.36%-7.7%) A 4.2% CI, 4.2%-10.4%) B. 5-year DDFS B 92% 83%-97%) 89% 81%-94%), respectively. CONCLUSIONS Longer these studies has demonstrated ddACTH only or is associated low risk promising cancer. Cancer 2013;119:3943–3951. © 2013 American Society.