Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines
Abstract Background Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity. Methods Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four week...
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| Veröffentlicht in: | The American journal of surgery 2009-10, Vol.198 (4), p.488-494 |
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| creator | Bahl, Susan, M.D Roses, Robert E., M.D Sharma, Anupama, M.D Koldovsky, Ursula, Ph.D Xu, Shuwen, M.D Weinstein, Susan, M.D Nisenbaum, Harvey, M.D Fox, Kevin, M.D Pasha, Theresa Zhang, Paul, M.D., Ph.D Araujo, Louis, M.D Carver, Joseph, M.D Czerniecki, Brian J., M.D., Ph.D |
| description | Abstract Background Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity. Methods Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function. Results In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses. Conclusions This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function. |
| doi_str_mv | 10.1016/j.amjsurg.2009.06.014 |
| format | Article |
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Methods Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function. Results In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses. Conclusions This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2009.06.014</identifier><identifier>PMID: 19800453</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Breast cancer ; Breast Neoplasms - therapy ; Cancer Vaccines - adverse effects ; Carcinoma, Intraductal, Noninfiltrating - therapy ; Cardiac toxicity ; DCIS ; Dendritic Cells ; ErbB-2 protein ; Female ; General aspects ; Genes, erbB-2 ; Heart ; Heart diseases ; HER-2 ; Humans ; Immune response ; Immune response (cell-mediated) ; Immunization ; Immunotherapy ; Incidence ; Kinases ; Mammography ; Mastectomy ; Medical sciences ; Middle Aged ; Monoclonal antibodies ; Patients ; Prevention and actions ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Scanning ; Stroke Volume ; Surgery ; Targeted cancer therapy ; Toxicity ; Trastuzumab ; Vaccinations ; Vaccines ; Ventricular Dysfunction - etiology ; Ventricular Dysfunction - physiopathology</subject><ispartof>The American journal of surgery, 2009-10, Vol.198 (4), p.488-494</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited Oct 1, 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c523t-c99633bc40b077426456121775cd1824f08c709f37995f04db825861072b6d333</citedby><cites>FETCH-LOGICAL-c523t-c99633bc40b077426456121775cd1824f08c709f37995f04db825861072b6d333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1924858666?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997,64387,64391,72471</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22014020$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19800453$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bahl, Susan, M.D</creatorcontrib><creatorcontrib>Roses, Robert E., M.D</creatorcontrib><creatorcontrib>Sharma, Anupama, M.D</creatorcontrib><creatorcontrib>Koldovsky, Ursula, Ph.D</creatorcontrib><creatorcontrib>Xu, Shuwen, M.D</creatorcontrib><creatorcontrib>Weinstein, Susan, M.D</creatorcontrib><creatorcontrib>Nisenbaum, Harvey, M.D</creatorcontrib><creatorcontrib>Fox, Kevin, M.D</creatorcontrib><creatorcontrib>Pasha, Theresa</creatorcontrib><creatorcontrib>Zhang, Paul, M.D., Ph.D</creatorcontrib><creatorcontrib>Araujo, Louis, M.D</creatorcontrib><creatorcontrib>Carver, Joseph, M.D</creatorcontrib><creatorcontrib>Czerniecki, Brian J., M.D., Ph.D</creatorcontrib><title>Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity. Methods Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function. Results In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses. Conclusions This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer Vaccines - adverse effects</subject><subject>Carcinoma, Intraductal, Noninfiltrating - therapy</subject><subject>Cardiac toxicity</subject><subject>DCIS</subject><subject>Dendritic Cells</subject><subject>ErbB-2 protein</subject><subject>Female</subject><subject>General aspects</subject><subject>Genes, erbB-2</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>HER-2</subject><subject>Humans</subject><subject>Immune response</subject><subject>Immune response (cell-mediated)</subject><subject>Immunization</subject><subject>Immunotherapy</subject><subject>Incidence</subject><subject>Kinases</subject><subject>Mammography</subject><subject>Mastectomy</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Patients</subject><subject>Prevention and actions</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Scanning</subject><subject>Stroke Volume</subject><subject>Surgery</subject><subject>Targeted cancer therapy</subject><subject>Toxicity</subject><subject>Trastuzumab</subject><subject>Vaccinations</subject><subject>Vaccines</subject><subject>Ventricular Dysfunction - etiology</subject><subject>Ventricular Dysfunction - physiopathology</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFks9u1DAQxiMEokvhEUCWEMekYztx4guoqgpFqoTEn7PlHTtbL4mz2E6rvfEOHHk7ngSHXVGJCyfL4998M55viuI5hYoCFWfbSo_bOIdNxQBkBaICWj8oVrRrZUm7jj8sVgDASikonBRPYtzmK6U1f1ycUNkB1A1fFT_P437cpWnUySHBG-03NhLnCepgnEbSzx6Tm5aAJxPiHJZXM2PSwwKh8zm5dL6MLs1kl3WsT5H00zBMd85vSApWpzEHyZ1LN-Tq8mPJzrydf33_sZuHaA0x1pvg_jRgh4HcasyqNj4tHvU6A8-O52nx5e3l54ur8vrDu_cX59clNoynEqUUnK-xhjW0bc1E3QjKaNs2aGjH6h46bEH2vJWy6aE26441XZ5Ky9bCcM5Pi5cH3V2Yvs02JrWd5uBzSUUlq7sMC5Gp5kBhmGIMtle74EYd9oqCWixRW3W0RC2WKBAqW5LzXhzV5_VozX3W0YMMvDoCOqIe-qA9uviXYyyrAIPMvTlwNs_i1tmgIuZZozUuWEzKTO6_rbz-RwEH510u-tXubbz_tYpMgfq07M-yPiBzpyAo_w3HqcMy</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Bahl, Susan, M.D</creator><creator>Roses, Robert E., M.D</creator><creator>Sharma, Anupama, M.D</creator><creator>Koldovsky, Ursula, Ph.D</creator><creator>Xu, Shuwen, M.D</creator><creator>Weinstein, Susan, M.D</creator><creator>Nisenbaum, Harvey, M.D</creator><creator>Fox, Kevin, M.D</creator><creator>Pasha, Theresa</creator><creator>Zhang, Paul, M.D., Ph.D</creator><creator>Araujo, Louis, M.D</creator><creator>Carver, Joseph, M.D</creator><creator>Czerniecki, Brian J., M.D., Ph.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>20091001</creationdate><title>Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines</title><author>Bahl, Susan, M.D ; Roses, Robert E., M.D ; Sharma, Anupama, M.D ; Koldovsky, Ursula, Ph.D ; Xu, Shuwen, M.D ; Weinstein, Susan, M.D ; Nisenbaum, Harvey, M.D ; Fox, Kevin, M.D ; Pasha, Theresa ; Zhang, Paul, M.D., Ph.D ; Araujo, Louis, M.D ; Carver, Joseph, M.D ; Czerniecki, Brian J., M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c523t-c99633bc40b077426456121775cd1824f08c709f37995f04db825861072b6d333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - therapy</topic><topic>Cancer Vaccines - adverse effects</topic><topic>Carcinoma, Intraductal, Noninfiltrating - therapy</topic><topic>Cardiac toxicity</topic><topic>DCIS</topic><topic>Dendritic Cells</topic><topic>ErbB-2 protein</topic><topic>Female</topic><topic>General aspects</topic><topic>Genes, erbB-2</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>HER-2</topic><topic>Humans</topic><topic>Immune response</topic><topic>Immune response (cell-mediated)</topic><topic>Immunization</topic><topic>Immunotherapy</topic><topic>Incidence</topic><topic>Kinases</topic><topic>Mammography</topic><topic>Mastectomy</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Patients</topic><topic>Prevention and actions</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Scanning</topic><topic>Stroke Volume</topic><topic>Surgery</topic><topic>Targeted cancer therapy</topic><topic>Toxicity</topic><topic>Trastuzumab</topic><topic>Vaccinations</topic><topic>Vaccines</topic><topic>Ventricular Dysfunction - etiology</topic><topic>Ventricular Dysfunction - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bahl, Susan, M.D</creatorcontrib><creatorcontrib>Roses, Robert E., M.D</creatorcontrib><creatorcontrib>Sharma, Anupama, M.D</creatorcontrib><creatorcontrib>Koldovsky, Ursula, Ph.D</creatorcontrib><creatorcontrib>Xu, Shuwen, M.D</creatorcontrib><creatorcontrib>Weinstein, Susan, M.D</creatorcontrib><creatorcontrib>Nisenbaum, Harvey, M.D</creatorcontrib><creatorcontrib>Fox, Kevin, M.D</creatorcontrib><creatorcontrib>Pasha, Theresa</creatorcontrib><creatorcontrib>Zhang, Paul, M.D., Ph.D</creatorcontrib><creatorcontrib>Araujo, Louis, M.D</creatorcontrib><creatorcontrib>Carver, Joseph, M.D</creatorcontrib><creatorcontrib>Czerniecki, Brian J., M.D., Ph.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bahl, Susan, M.D</au><au>Roses, Robert E., M.D</au><au>Sharma, Anupama, M.D</au><au>Koldovsky, Ursula, Ph.D</au><au>Xu, Shuwen, M.D</au><au>Weinstein, Susan, M.D</au><au>Nisenbaum, Harvey, M.D</au><au>Fox, Kevin, M.D</au><au>Pasha, Theresa</au><au>Zhang, Paul, M.D., Ph.D</au><au>Araujo, Louis, M.D</au><au>Carver, Joseph, M.D</au><au>Czerniecki, Brian J., M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>198</volume><issue>4</issue><spage>488</spage><epage>494</epage><pages>488-494</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity. Methods Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function. Results In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses. Conclusions This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19800453</pmid><doi>10.1016/j.amjsurg.2009.06.014</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Breast cancer Breast Neoplasms - therapy Cancer Vaccines - adverse effects Carcinoma, Intraductal, Noninfiltrating - therapy Cardiac toxicity DCIS Dendritic Cells ErbB-2 protein Female General aspects Genes, erbB-2 Heart Heart diseases HER-2 Humans Immune response Immune response (cell-mediated) Immunization Immunotherapy Incidence Kinases Mammography Mastectomy Medical sciences Middle Aged Monoclonal antibodies Patients Prevention and actions Public health. Hygiene Public health. Hygiene-occupational medicine Scanning Stroke Volume Surgery Targeted cancer therapy Toxicity Trastuzumab Vaccinations Vaccines Ventricular Dysfunction - etiology Ventricular Dysfunction - physiopathology |
| title | Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu–pulsed dendritic cell vaccines |
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