Breast Cancer Chemotherapy and Heart Problems

Breast cancer chemotherapy drugs increase CVD risks

(RxWiki News) A common treatment for breast cancer is chemotherapy. This involves using different drugs to kill cancer cells wherever they are in the body. Two commonly used chemotherapy drugs have some dangerous side effects.

Women with breast cancer who have been treated with Herceptin (trastuzumab) and/or anthracyline are at greater risk of heart problems. These dangers are greater than previous studies have shown.

"Ask your doctor about tests before chemotherapy."

This is what Cancer Research Network study by Group Health researchers and others has uncovered.

“The study is significant because more and more women are surviving longer with breast cancer, so it's becoming a chronic disease,” said lead author Erin Aiello Bowles, MPH, of the Group Health Research Institute.

Earlier studies had suggested that the use of either of these drugs increased a woman’s risk of heart failure and cardiomyopathy (weakening of the heart muscle). The design of those studies left out a number of women, which may have skewed the results.

This population-based, retrospective (looking at past results) study involved 12,500 who had invasive breast cancer.

Those who had been given an anthracycline alone had significantly higher risks of developing heart failure, cardiomyopathy or both than women who did not get the drug.

Risks of heart problems were even greater in women who received Herceptin. And the highest cardiac risks were seen in women who used both drugs.

“The high incidence of heart failure seen in this "real world" experience is concerning, and needs to be further evaluated to determine the true risk of cardimyopathy from perception and anthracycline containing regimens,” breast cancer specialist Adam Brufsky, MD, PhD told dailyRx News.

“Nonetheless, I think this may make some of us who use Herceptin with an anthracycline in the adjvuant [after surgery] therapy of breast cancer think twice, and consider non-anthrcycline containing regimens such as TCH for these early stage patients,” said Dr. Brufsky, professor of medicine at the University of Pittsburgh School of Medicine

Anthracylines are a class of drugs sold under a number of trade names, including Adriamycin (doxorubicin). Nicknamed the "red devil," it's one of the most powerful chemotherapies used for a number of cancers.

This medication is often part of a combination chemo regimen to treat breast cancer. Anthracyclines can have mean side effects, including hair loss, nail changes, nausea/vomiting among others.

The study found that women who received anthracycline alone or in combination tended to be younger and healthier. Women given Herceptin were generally older and had more health conditions.

Ms. Bowles said, “These drugs are still important for women with breast cancer to use because we know they improve survival. But as with any drug, people need to be aware of the risks, too."

This study was published August 30 in the Journal of the National Cancer Institute and funded by The National Cancer Institute at the National Institutes of Health.

Review Date: 
September 11, 2012