Cardiotoxicity, Thrombosis and Bleeding Associated with Anticancer Treatment Regimens
In addition to baseline evaluation, at which of the following points do you generally assess cardiac function in patients receiving trastuzumab in the following settings? (Check all that apply)
In addition to baseline evaluation, at which of the following points do you generally assess cardiac function in patients receiving trastuzumab in the following settings? (Check all that apply)
A 63-year-old woman with hypertension and ER/PR-negative, HER2-positive, node-positive breast cancer is treated with dose-dense AC for 4 cycles, with plans to follow this with concurrent weekly paclitaxel and trastuzumab for 12 weeks followed by trastuzumab alone to 1 year. Baseline MUGA prior to initiation of chemotherapy showed a left ventricular ejection fraction (LVEF) of 66%, and repeat MUGA after the 4 cycles of AC shows an LVEF of 50% (lower limit of institutional normal).
A 63-year-old woman with hypertension and ER/PR-negative, HER2-positive, node-positive breast cancer is treated with dose-dense AC for 4 cycles, with plans to follow this with concurrent weekly paclitaxel and trastuzumab for 12 weeks followed by trastuzumab alone to 1 year. Baseline MUGA prior to initiation of chemotherapy showed a left ventricular ejection fraction (LVEF) of 66%, and repeat MUGA after the 4 cycles of AC shows an LVEF of 50% (lower limit of institutional normal).
A 43-year-old woman with ER/PR-negative, HER2-positive, node-positive breast cancer is treated with dose-dense AC, followed by concurrent weekly paclitaxel and trastuzumab for 12 weeks, followed by trastuzumab every 3 weeks. The patient has an EF of 60% prior to initiation of trastuzumab, which decreases to 45% after 6 months of trastuzumab. The patient is asymptomatic. Trastuzumab is discontinued for 4 weeks, and without any other interventions, the patient’s EF increases to 50%.
A 43-year-old woman with ER/PR-negative, HER2-positive, node-positive breast cancer is treated with dose-dense AC, followed by concurrent weekly paclitaxel and trastuzumab for 12 weeks, followed by trastuzumab every 3 weeks. The patient has an EF of 60% prior to initiation of trastuzumab, which decreases to 45% after 6 months of trastuzumab. The patient is asymptomatic. Trastuzumab is discontinued for 4 weeks, and without any other interventions, the patient’s EF increases to 50%.
For a woman in average health with a 1.2-cm, Grade II, ER-positive/PR-positive, HER2-positive tumor with 3 positive nodes, how would you compare TCH to your preferred anthracycline/taxane/trastuzumab regimen?
For a woman in average health with a 1.2-cm, Grade II, ER-positive/PR-positive, HER2-positive tumor with 3 positive nodes, how would you compare TCH to your preferred anthracycline/taxane/trastuzumab regimen?
At what persistent blood pressure do you generally initiate antihypertensive therapy for a patient without cardiac risk factors who is receiving bevacizumab for metastatic disease?
Which of the following tyrosine kinase inhibitors (TKIs) have you used?
A 53-year-old man with metastatic colon cancer is receiving treatment with FOLFOX/bevacizumab and presents with DVT/PE. He is treated acutely with LMWH at a therapeutic (full) dose for 5 days and has an uncomplicated course. You expect to continue the same chemotherapy regimen after the patient’s condition becomes stable.
A 53-year-old man with metastatic colon cancer is receiving treatment with FOLFOX/bevacizumab and presents with DVT/PE. He is treated acutely with LMWH at a therapeutic (full) dose for 5 days and has an uncomplicated course. You expect to continue the same chemotherapy regimen after the patient’s condition becomes
A 53-year-old man with metastatic colon cancer is receiving treatment with FOLFOX/bevacizumab and presents with DVT/PE. He is treated acutely with LMWH at a therapeutic (full) dose for 5 days and has an uncomplicated course. You expect to continue the same chemotherapy regimen after the patient’s condition becomes stable
.
A patient is receiving CAPOX in combination with bevacizumab as treatment for metastatic colon cancer and is responding well to treatment. However, after 2 months of treatment, he requires a Mediport
®
due to loss of all peripheral venous access. It is inserted without complications or wound-healing problems.
A patient is receiving CAPOX in combination with bevacizumab as treatment for metastatic colon cancer and is responding well to treatment. However, after 2 months of treatment, he requires a Mediport® due to loss of all peripheral venous access. It is inserted without complications or wound-healing problems. (Continued)
A 52-year-old man with Stage IV nonsquamous non-small cell lung cancer (NSCLC) is undergoing treatment with paclitaxel/carboplatin/ bevacizumab and is responding to treatment. Three months into treatment, the patient begins developing hemoptysis despite radiographic improvement. It is reasonable to continue with bevacizumab in this situation.
Which of the following tumor characteristics do you consider to be the most important predisposing risk factor for hemoptysis in patients with NSCLC receiving bevacizumab?
