Document Detail


Simultaneous hemodynamic and serological cardiotoxicity monitoring during immunotherapy with trastuzumab.
MedLine Citation:
PMID:  17400308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Immunotherapy with trastuzumab (Herceptin), a selective HER-2(ErbB2)-antibody, is associated with a certain degree of cardiotoxicity. This study sought to evaluate the immediate hemodynamic response to trastuzumab with real-time CW-Doppler depending on the level of nt-pro-BNP (brain natriuretic peptide) as a possible marker of cardiotoxicity.
METHODS: 48 patients with HER-2-positive metastatic breast cancer were continuously measured with CW-Doppler ultrasound for cardiac output (CO) and systemic vascular resistance (SVR) before, during and after drug infusion in combination with nt-pro-BNP before and 10 min after drug infusion. Depending on the nt-pro-BNP-levels <125 pg/ml (group A, n=34, 51+/-11 years) vs. nt-pro-BNP >125 pg/ml (group B, n=14, 63+/-7 years) two groups have been defined.
RESULTS: Trastuzumab therapy did not change nt-pro-BNP immediately before (44+/-29 pg/ml) vs. after the infusion (45+/-32 pg/ml, n.s.) in the low-level as in the high level nt-pro-BNP group (231+/-356 pg/ml prior and 240+/-377 pg/ml, n.s.). Cardiac output remained stable during trastuzumab infusion, however cardiac output was significantly increased following the end of the infusion stronger in the high-level nt-pro-BNP group. Systemic vascular resistance prior to the trastuzumab infusion was higher in the high-level nt-pro-BNP group with significant decrement during and after the infusion.
CONCLUSION: Combining real-time CW-Doppler ultrasound and nt-pro-BNP monitoring is feasible to monitor the immediate hemodynamic changes during and after trastuzumab infusion.
Authors:
K Knobloch; J Tepe; R Lichtinghagen; H J Luck; P M Vogt
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Publication Detail:
Type:  Letter     Date:  2007-04-02
Journal Detail:
Title:  International journal of cardiology     Volume:  125     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-05     Completed Date:  2008-05-22     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  113-5     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / administration & dosage,  adverse effects*
Antibodies, Monoclonal, Humanized
Antigens, Neoplasm / blood
Antineoplastic Agents / administration & dosage,  adverse effects*
Biological Markers / blood
Cardiac Output
Heart / drug effects*
Hemodynamics / drug effects*
Humans
Immunotherapy / adverse effects*,  methods
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Receptor, erbB-2 / immunology*
Risk Factors
Stroke Volume
Time Factors
Vascular Resistance
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antigens, Neoplasm; 0/Antineoplastic Agents; 0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; EC 2.7.10.1/Receptor, erbB-2; P188ANX8CK/trastuzumab

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