(194) Rates of Cardiotoxicity in Patients Receiving Chemo-immunotherapy with Anthracyclines Compared to Chemotherapy with Anthracyclines Alone

Poster Abstract: Background/Rationale:
Doxorubicin is routinely utilized in the management of breast cancer. Anthracyclines are known to increase the risk of cardiotoxicities among cancer patients, and the recent addition of immunotherapy for patients with high risk early-stage triple negative breast cancer based on the KEYNOTE-522 trial presents a concern for cumulative cardiotoxicities. However, the incidence of cardiotoxicity in this combination has been poorly reported due to a lack of long-term trial follow-up from KEYNOTE-522 and an absence of clear guidance on cardiovascular monitoring with these agents. The purpose of this study is to characterize the risk of cardiotoxicity with immunotherapy in combination with anthracyclines to promote changes in cardiovascular monitoring and management among patients with breast cancer.

Study Objectives
The primary objective is to evaluate the rates of cardiotoxicity in breast cancer patients receiving anthracyclines in combination with immunotherapy versus anthracyclines defined as a decrease of left ventricular ejection fraction (LVEF) by 5% or more to less than 55% in presence of symptoms of heart failure (HF) or an asymptomatic decrease in LVEF by 10% or more to less than 55%. The secondary objectives are to compare the percentage of patients who started medical management for heart failure following breast cancer treatment, experienced an LVEF drop, and received an echocardiogram in each arm.

Methods:
An estimated 200 patients that are 18 years of age and older with a diagnosis of breast cancer who received an anthracycline, immunotherapy, or both with the intention of treating breast cancer at West Virginia University Cancer Institute between January 1, 2017 and August 31, 2023 will be included in this institutional review board approved retrospective chart review. Data collection points include cardiac comorbidities, concomitant cardioprotective medications, cancer stage, treatment regimen including planned doses, dose reductions, dose delays, and treatment discontinuations, cardiac monitoring and cardiac adverse events.

Results and

Conclusions: Results and conclusions will be presented at the Hematology/Oncology Pharmacy Association Annual Conference.

References (must also be included in final poster): Authors: Charles Micheal Gallagher, PharmD (1);
Gary Monroe, DO (2); Michelle Hartzell, DO (2); Sonya Inderbitzen-Fischer, MD (3); Autumn Smith, PharmD (1); Jordan Hill, PharmD, BCOP (1); Sobha Kurian, MD (3); Brijesh Patel, DO (4)
1. Department of Pharmacy, West Virginia University Medicine, Morgantown, WV
2. Department of Medicine, West Virginia University Medicine, Morgantown, WV
3. Osborn Hematopoietic Malignancy and Cellular Therapy Program, West Virginia University Cancer Institute, Morgantown, WV
4. WVU Heart and Vascular Institute, West Virginia University Medicine, Morgantown, WV

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