LVEF affected by Herceptin

Has anyone else had to have their herceptin stopped because of MUGA scan result showing a marked reduction in lvef? My result dropped from 69% to 46% - clearly a third. Also has anyone with a low LVEF been given any advice re. dos and don’ts with physical activities, heavy lifting etc?
J

Hi Jayde,

I have been on herceptin for 3.5 years now and had a lot of fluctuation in the LVEF rate. I started with a baseline of 56% which gradually fell to 42%. However, as I had no other symptoms i.e. breathlessness or swollen ankles my onc agreed he would let me continue - the next time it went up to 68% and has since come down to 58%. The NICE guidelines on this are:

‘Cardiac functional assessments should be repeated every 3 months during trastuzumab treatment. If the LVEF drops by 10 percentage (ejection) points or more from baseline and to below 50% then trastuzumab treatment should be suspended…’

Usually you are given a break of 2-3mths and then a further MUGA is done - the heart function very often recovers and herceptin can be recommenced. I was never given any particular advice when mine fell other than to let the onc know if i got breathless at all. I suppose much depends on how closely your hospital adhere to the NICE guidelines. I persuaded my oncologist on the gounds that they had no further treatment to offer me then and without the herceptin my cancer was almost certain to spread further so I was prepared to take a chance. Again I do emphasise that he was happy to do this because I had no other symptoms.

Dawnhc

I’ve got the same problem at the moment, having had an echocardiogram 3 months into herceptin treatment which showed a deterioration. I’ve missed out on 1 dose of herceptin so far as a result of this & had a repeat echo earlier this week. I’m seeing my onc. on Friday for the results & to see whether they’re going to continue with the herceptin.

The onc. told me that a study has shown that people given a shorter course of herceptin had almost as good results as those who got it for a full year, so that’s made me feel a bit better about the prospect of not getting any more. Others I’ve spoken to in the same situation have said that the damage was only temporary and that once herceptin stopped things improved.

Hi Jayde

I started 18 x Herceptin May 2006 straight after 4xFEC and alongside 4xTaxotere chemo with a score of 65%, once I finished chemo my 2nd echo scored 64%, thought I was on a roll but 3rd scored 50%, I was really upset as I new treatment number 10 due 2 days later would be cancelled and then my Onc advised I would have a couple of months off treatment. I hated the thought of my heart being affected and the treatment dragging further into 2007 but in the end turned it around and looked at it as a little holiday and did I really wants bloods and to be weighed over December celebrations. In the end got rescanned early December and score was back to 65% so immediatley back on treatment and finished 1.6.07. roughly 6 weeks later then planned. Had further checks on 5.3.07 and 22.6.07 and both were still in the sixties.

Hopefully yours will be a one off like mine and you will soon be back on treatment.

Personally I have been advised no heavy lifting since op (full node clearance) but my Onc and surgeon have always encouraged me to carry on with walking, biking and general exercise.

Hope all goes well

Debbie X