ArticleBreast cancer research and treatment2014
Risk of cardiovascular adverse events from trastuzumab (Herceptin(®)) in elderly persons with breast cancer: a population-based study.
Article in Breast cancer research and treatment, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Social Determinants of Health and Cardiovascular Disease-Related Outcome Disparities Among Breast Cancer Survivors: A Systematic Review.Journal of the American Heart Association · 2026Pooled it
- SAFE-HEaRt: Rationale and Design of a Pilot Study Investigating Cardiac Safety of HER2 Targeted Therapy in Patients with HER2-Positive Breast Cancer and Reduced Left Ventricular Function.The oncologist · 2017Trial
- From data to decision: a clinical pipeline for wearable AI in early cardiotoxicity detection.Cardio-oncology (London, England) · 2026Review
- Observational study of trastuzumab biosimilar in patients with HER2-positive breast cancer under routine clinical practice conditions in Morocco.BMC cancer · 2026Observational
- Cardiotoxicity in Elderly Breast Cancer Patients.Cancers · 2025Review
- Examining factors associated with experiencing cardiac arrhythmias in Black and White breast cancer survivors who received anthracyclines or trastuzumab.Breast cancer research and treatment · 2025Article
- Predictive Modeling of Long-Term Survivors with Stage IV Breast Cancer Using the SEER-Medicare Dataset.Cancers · 2024Article
- Review
- Racial disparities in treatment-related cardiovascular toxicities amongst women with breast cancer: a scoping review.Journal of cancer survivorship : research and practice · 2023Article
- Characteristics and research status among clinical trials in cardio-oncology by bibliometric and visualized analysis.Cancer medicine · 2023Review
- Cardiotoxicity among socioeconomically marginalized breast cancer patients.Breast cancer research and treatment · 2022Article
- Cardioprotection for Anti-HER2 Therapy: Considerations for Primary Prevention and Use in Mildly Reduced Left Ventricular Ejection Fraction.Current oncology reports · 2022Review
- NT-proBNP as predictor factor of cardiotoxicity during trastuzumab treatment in breast cancer patients.Breast (Edinburgh, Scotland) · 2020Observational
- Strategies to Prevent Cardiovascular Toxicity in Breast Cancer: Is It Ready for Primetime?Journal of clinical medicine · 2020Review
- Practical and cost-effective model to build and sustain a cardio-oncology program.Cardio-oncology (London, England) · 2020Article
- Primary systemic therapy in HER2-positive operable breast cancer using trastuzumab and chemotherapy: efficacy data, cardiotoxicity and long-term follow-up in 142 patients diagnosed from 2005 to 2016 at a single institution.Breast cancer (Dove Medical Press) · 2019Article
- Galician consensus on management of cardiotoxicity in breast cancer: risk factors, prevention, and early intervention.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2017Article
- Initiation of Trastuzumab by Women Younger Than 64 Years for Adjuvant Treatment of Stage I-III Breast Cancer.Journal of the National Comprehensive Cancer Network : JNCCN · 2017Article
- Screening-relevant age threshold of 70 years and older is a stronger determinant for the choice of adjuvant treatment in breast cancer patients than tumor biology.Breast cancer research and treatment · 2017Article
- Observational
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
Abstract
Randomized controlled trials have reported a 4-5 times increased risk of heart failure (HF) in breast cancer patients receiving trastuzumab (Herceptin (®) ) compared to patients who do not receive trastuzumab. However, data regarding the cardiac effects of trastuzumab on elderly patients treated in general practice remain very limited. Using the US surveillance, epidemiology, and end results (SEER)-Medicare database, we conducted a retrospective cohort study on the cardiac effects of trastuzumab use in all incident breast cancer patients diagnosed from 1998 to 2007 who were 66 years and older, had no prior recent claims for cardiomyopathy (CM) or HF, and were followed through 2009. We defined our outcome as the first CM/HF event after diagnosis. We performed Cox-proportional hazard models with propensity score adjustment to estimate CM/HF risk associated with trastuzumab use. A total of 6,829 out of 68,536 breast cancer patients (median age: 75) had an incident CM/HF event. Patients who received trastuzumab tended to be younger, non-white, diagnosed more recently, and had a stage IV diagnosis. Trastuzumab use was associated with an increased risk of CM/HF (HR = 2.08, 95 % CI 1.77-2.44, p < 0.001). The trastuzumab-associated CM/HF risk was stronger in patients who were younger (HR = 2.52 for 66-75 years and HR = 1.44 for 76 years and older, p < 0.001) and diagnosed in recent years (HR = 2.58 for 2006-2007 vs. 1.86 for 1998-2005, p = 0.01). The twofold risk of CM/HF associated with trastuzumab remained regardless of patients' diagnosis stage, presence of hypertension, cardiovascular comorbidities, or receipt of anthracyclines, taxanes, or radiation. Trastuzumab may double CM/HF risk among elderly breast cancer patients. Our findings reinforce the need to prevent and manage cardiac risk among elderly breast cancer patients receiving trastuzumab.
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