Safety of Continuing Trastuzumab for Mild Cardiotoxicity: A Cardiovascular Magnetic Resonance Imaging Study
Bibliographic record
Abstract
The safety of continuing human epidermal growth factor receptor 2 (HER2)–targeted therapy in women with mild cardiotoxicity remains unclear. We performed a retrospective matched cohort study of 14 patients with human epidermal growth factor receptor 2–positive breast cancer receiving sequential anthracycline and trastuzumab therapy, nested within the E valuation of M yocardial Changes During Br east A denocarcinoma Therapy to Detect C ardiotoxicity E arlier With MRI (EMBRACE-MRI) trial. Among patients who developed cardiotoxicity and were treated with heart failure therapy, we compared those who had trastuzumab therapy interrupted to a matched cohort who continued trastuzumab therapy. By a median of 2.5 years of follow-up, no significant differences were present between the groups in the proportion with magnetic resonance imaging–measured left ventricular ejection fraction < 40%, magnetic resonance imaging–measured left ventricular volumes, left ventricular ejection fraction, edema, fibrotic markers, cardiopulmonary fitness, or quality of life. La question de savoir s’il est sûr de poursuivre le traitement par un médicament ciblant le récepteur 2 du facteur de croissance épidermique humain (HER2) en présence d’une légère cardiotoxicité chez la femme demeure controversée. Nous avons réalisé une étude de cohortes appariées rétrospective auprès de 14 patientes atteintes d’un cancer du sein positif pour le HER2 qui recevaient un traitement séquentiel par l’anthracycline et le trastuzumab, dans le cadre du programme EMBRACE-MRI ( E valuation of M yocardial Changes During Br east A denocarcinoma Therapy to Detect C ardiotoxicity E arlier With MRI ). Parmi les patientes ayant développé une cardiotoxicité et ayant reçu un traitement pour l’insuffisance cardiaque, nous avons comparé celles dont le traitement par le trastuzumab a été interrompu à une cohorte appariée ayant poursuivi ce traitement. Après un suivi médian de 2,5 ans, aucune différence significative n’avait été observée entre les groupes en ce qui concerne le pourcentage de patientes dont la fraction d’éjection ventriculaire gauche était inférieure à 40 % à l’imagerie par résonance magnétique (IRM), le volume ventriculaire gauche à l’IRM, la fraction d’éjection ventriculaire gauche, l’œdème, les marqueurs fibrotiques, la bonne forme physique de l’appareil cardio-pulmonaire ou la qualité de vie.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".