Pulmonary arterial hypertension in breast cancer patients on HER2-targeted therapy: a review of FDA Adverse Events Reporting System data

Umoru, Godsfavour; Taitano, Matthew; Beshay, Sarah; Niravath, Polly; Sahay, Sandeep

doi:10.1183/23120541.00199-2020

Cited by 4 publications

(3 citation statements)

References 5 publications

(13 reference statements)

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“…13 , 15 Pulmonary hypertension was also 3.34 times more likely to occur in patients receiving ado-trastuzumab emtansine than other chemotherapy regimens, which may affect the ability of patients to tolerate general anesthesia. 16 Finally, patients receiving ado-trastuzumab emtansine are 10.66-fold more likely to experience severe thrombocytopenia and experience neutropenia with an incidence rate of 6.7%. 13 , 16 In addition to routine laboratories, thorough preoperative evaluation of patients receiving trastuzumab includes transthoracic echocardiography for assessment of heart failure and severe pulmonary hypertension and a liver function panel for assessment of hepatitis.…”

Section: Anti-human Epidermal Growth Factor Receptormentioning

confidence: 99%

“… 16 Finally, patients receiving ado-trastuzumab emtansine are 10.66-fold more likely to experience severe thrombocytopenia and experience neutropenia with an incidence rate of 6.7%. 13 , 16 In addition to routine laboratories, thorough preoperative evaluation of patients receiving trastuzumab includes transthoracic echocardiography for assessment of heart failure and severe pulmonary hypertension and a liver function panel for assessment of hepatitis. Given the risk for thrombocytopenia and neutropenia, low thresholds for suspicion of postoperative infection or hematomas are also advised.…”

Section: Anti-human Epidermal Growth Factor Receptormentioning

confidence: 99%

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Breast Cancer Immunotherapy: A Clinical Review for the Plastic Surgeon

Heron,

Zhu,

Zhu

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Immunotherapy has transformed breast cancer management. However, it can be challenging to remain familiar with the adverse events, contraindications, and perioperative recommendations for each agent. Methods: We used FDALabel to identify all Food and Drug Administration–approved immunotherapies indicated for the treatment of breast cancer. We extracted details regarding warnings and precautions, indications, and adverse events from each package insert. Results: We identified nine immunotherapies belonging to three classes: anti-human epidermal growth factor receptor 2 (HER2) agents, anti-programmed cell death protein 1 (PD-1) agents, and anti-trophoblast cell-surface antigen 2 (TROP-2) agents. Cardiotoxicity, including heart failure and cardiomyopathy, was common among those receiving anti-HER2 agents, and hypothyroidism was common among patients receiving the anti-PD-1 agent. The anti-TROP-2 agent was associated with diarrhea and neutropenia. Given the adverse event profile for each drug, we recommend preoperative evaluation components, including transthoracic echocardiography, liver function tests, and thyroid panels. We also indicate here which immunotherapies raise concern for venous thromboembolism, hematoma, and infection. Conclusions: Using data from clinical trials, we recommend a preoperative evaluation tailored to the immunotherapeutic regimen of individual patients.

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Section: Anti-human Epidermal Growth Factor Receptormentioning

confidence: 99%

Section: Anti-human Epidermal Growth Factor Receptormentioning

confidence: 99%

Breast Cancer Immunotherapy: A Clinical Review for the Plastic Surgeon

Heron,

Zhu,

Zhu

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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“…Similarly, in a small study of 27 patients treated with lapatinib showed an increase of pulmonary artery systolic pressure (PASP) on TTE after treatment [ 76 ]. Unlike erlotinib and gefitinib, lapatinib inhibits human epidermal growth factor receptor 2 (HER2) that may be responsible for the development of PH though further studies are needed [ 77 ]. Another TKI that has been associated with PH is ruxolitinib, a Janus kinase (JAK) 1/JAK2 inhibitor used in the treatment of myelofibrosis and polycythemia vera.…”

Section: Tyrosine Kinase Inhibitors and Pulmonary Arterial Hypertensionmentioning

confidence: 99%

Cancer Therapy-Associated Pulmonary Hypertension and Right Ventricular Dysfunction: Etiologies and Prognostic Implications

Leiva,

Beaty,

Soo

et al. 2024

Rev. Cardiovasc. Med.

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Advances in cancer therapies have improved oncologic outcomes but can potentially expose patients to risk of cardiovascular toxicity. While left ventricular (LV) dysfunction is a well-known cardiotoxicity of cancer therapy. Pulmonary hypertension (PH) and right ventricular (RV) dysfunction are seen with several cancer therapies, including alkylating agents, tyrosine kinase inhibitors (TKIs), and immunotherapy, and are associated with significant morbidity and mortality. Awareness and recognition of cancer therapy-associated PH and RV dysfunction is critical to identify underlying etiologies and institute the appropriate therapy. However, gaps exist in the current literature on the epidemiology of PH and RV dysfunction in cancer, underlying pathophysiology and optimal management strategies.

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Trastuzumab-emtansine

2020

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Pulmonary arterial hypertension in breast cancer patients on HER2-targeted therapy: a review of FDA Adverse Events Reporting System data

Cited by 4 publications

References 5 publications

Breast Cancer Immunotherapy: A Clinical Review for the Plastic Surgeon

Breast Cancer Immunotherapy: A Clinical Review for the Plastic Surgeon

Cancer Therapy-Associated Pulmonary Hypertension and Right Ventricular Dysfunction: Etiologies and Prognostic Implications

Trastuzumab-emtansine

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