NCCN 2023: ECHO Monitoring for Patients Receiving Anti-HER2 Therapy for Breast Cancer

Echocardiogram (ECHO) monitoring for patients undergoing anti-HER2 therapy for breast cancer should be continued and extended based on patient risk factors, according to a poster presented at the NCCN 2023 Annual Conference. “Patients with cardiovascular risk factors are 1.6 times more at risk of cardiotoxicity during treatment,” said Annette P. Hood, PharmD, BCACP, of Smilow Cancer Hospital at Yale New Haven Health, Connecticut, and colleagues. “Additional data on the frequency of ECHO monitoring is needed to eliminate unnecessary testing and treatment delays while maintaining cardiac safety.”

The retrospective study focused on data from 153 patients with stage I to IV HER2-positive breast cancer who received anti-HER2 therapy. The authors analyzed data associated with dosing and the development of cardiac events, cardiovascular risk factors, and frequency of ECHO monitoring.

The group reported that 10% of patients had dosing held for development of a cardiac event. Of these patients, 25% had previously received anthracycline, none had a baseline ECHO of less than 55%, and 56% of these patients had two or more cardiac risk factors. Within 3 months of treatment, 43% of patients experienced a cardiac event, with a mean onset of 26.4 weeks. Events included a drop in ejection fraction, structural change via ECHO, and arrhythmia.

The group went on to report that just 5.2% of patients had no baseline cardiac risk factors or history of anthracycline therapy yet still developed a cardiac event. Because the occurrence of cardiac events in patients with no risk factors is less likely, the group suggested that surveillance could be extended to every 6 months; however, patients with risk factors and prior treatment with anthracycline should continue surveillance every 3 months.

Disclosure: Dr. Hood reported no conflicts of interest.

NCCN 2023 Annual Conference

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