Development of cardiac risk prediction model in patients with HER-2 positive breast cancer on trastuzumab therapy.

Autor: Otchere P; The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA., Adekoya O; Kettering Medical Center, Kettering, OH, USA., Governor SB; Washington University School of Medicine, St. Louis, MO, USA., Vuppuluri N; Kettering Medical Center, Kettering, OH, USA., Prabhakar A; Wright State University, Dayton, OH, USA., Pak S; Albany Medical Center, Albany, NY, USA. stellacpak@outlook.com., Oppong-Nkrumah O; McGill University, Montreal, QC, Canada., Cook F; Harvard University, Cambridge, MA, USA., Bohinc R; Kettering Medical Center, Kettering, OH, USA., Aune G; The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Jazyk: angličtina
Zdroj: Cardio-oncology (London, England) [Cardiooncology] 2023 May 19; Vol. 9 (1), pp. 26. Date of Electronic Publication: 2023 May 19.
DOI: 10.1186/s40959-023-00177-y
Abstrakt: Background: 25% of all breast cancer patients have HER-2 overexpression. Breast Cancer patients with HER-2 overexpression are typically treated with HER-2 inhibitors such as Trastuzumab. Trastuzumab is known to cause a decrease in left ventricular ejection fraction. The aim of this study is to create a cardiac risk prediction tool among women with Her-2 positive breast cancer to predict cardiotoxicity.
Method: Using a split sample design, we created a risk prediction tool using patient level data from electronic medical records. The study included women 18 years of age and older diagnosed with HER-2 positive breast cancer who received Trastuzumab. Outcome measure was defined as a drop in LVEF by more than 10% to less than 53% at any time in the 1-year study period. Logistic regression was used to test predictors.
Results: The cumulative incidence of cardiac dysfunction in our study was 9.4%. The sensitivity and specificity of the model are 46% and 84%, respectively. Given a cumulative incidence of cardiotoxicity of 9%, the negative predictive value of the test was 94%. This suggests that in a low-risk population, the interval of screening for cardiotoxicity may be performed less frequently.
Conclusion: Cardiac risk prediction tool can be used to identify Her-2 positive breast cancer patients at risk of developing cardiac dysfunction. Also, test characteristics in addition to disease prevalence may inform a rational strategy in performing cardiac ultrasound in Her-2 breast cancer patients. We have developed a cardiac risk prediction model with high NPV in a low-risk population which has an appealing cost-effectiveness profile.
(© 2023. The Author(s).)
Databáze: MEDLINE
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