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Herceptin patients face increased heart risk

But researchers assure patients that treatment poses an ìacceptable riskî

Roche's much-publicised treatment for breast cancer, Herceptin, carries the risk of heart damage, according to new research.

However, according to the team of scientists behind the study, this was an ìacceptable riskî for patients taking the drug as the damage could be repaired in the majority of cases.

Scientists at the University of Texas MD Anderson Center, writing in the Journal of Clinical Oncology, followed 173 patients with advanced breast cancer who had been taking Herceptin for one year. Each patient was given a cardiac assessment and they were then monitored for 32 months.

The study found 28 per cent of them (49 patients) had developed some form of damage to their hearts; the majority suffering damage linked to heart failure, and in one case leading to death.

Thirty-one of these patients suffered the damage while taking Herceptin alone, while the other 18 did so while taking Herceptin combined with chemotherapy treatment.

When the patients stopped taking Herceptin in favour of conventional heart drugs such as beta-blockers or ACE inhibitors, all but three of them had improved heart function. The researchers said Herceptin treatment could be resumed after the damage was repaired.

ìThe drug substantially prolongs survival and while we found substantial cardiac toxicity, we also discovered that this side-effect can be successfully treated, which was not clearly known before this study,î said lead author, Francisco Esteva. ìIf the cardiac side-effects of Herceptin treatment can be managed, the drug is safe to use.î

In June, the National Institute for Health and Clinical Excellence (NICE) backed the use of Herceptin for early-stage breast cancer, but stressed that heart function must be assessed beforehand. It also said that the drug should not be given to those at risk of heart failure and patients should undergo regular assessments.

Maria Leadbeater, a specialist nurse at Breast Cancer Care, said the study added to existing knowledge about the potential heart problems secondary breast cancer patients can develop with Herceptin.

ìThese side-effects appear to be largely reversible with treatment, and the authors suggest that people can be restarted on the drug if necessary,î she said.

The study did not involve patients with early-stage breast cancer.

30th September 2008

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