Early Cardiovascular Toxicity Observed in Young Women with Breast Cancer Treated with Chemo-Immunotherapy

Strategic Insights -

A new study from Cedars-Sinai Medical Center has found that young women with breast cancer who underwent chemo-immunotherapy treatment experienced early cardiovascular toxicity, even with a low cardiovascular risk profile. Researchers retrospectively analyzed 85 women with early-stage triple-negative breast cancer who received chemotherapy and pembrolizumab between 2018 and 2023. The median age of the patients was 50 years, and the majority had no detectable coronary artery calcium or known cardiovascular disease. However, 11% of the patients experienced a grade 2 cardiac event, with a one-year cumulative incidence of 9.6%. The study also found that the mean left anterior descending coronary artery radiation dose was associated with an increased risk of cardiac events.

Key Takeaways:

  • 85 women with early-stage triple-negative breast cancer were treated with chemotherapy-pembrolizumab between 2018 and 2023.
  • 11% of the patients experienced a grade 2 cardiac event, with a one-year cumulative incidence of 9.6%.
  • Most (7/9) grade 2 cardiac events were associated with a decline in ejection fraction.
  • Mean left anterior descending coronary artery radiation dose was associated with an increased risk of cardiac events.
  • QTc prolongation 450ms was more common during treatment vs. baseline (39% vs. 15%).
  • Early grade 2 EF decline recovered in 3/5 patients, but diastolic dysfunction persisted in 2/5 patients.

Statistics:

  • 85 women with early-stage triple-negative breast cancer were treated with chemotherapy-pembrolizumab.
  • 11% of the patients experienced a grade 2 cardiac event.
  • The one-year cumulative incidence of grade 2 cardiac events was 9.6%.
  • The median age of the patients was 50 years.
  • 39% of patients experienced QTc prolongation 450ms during treatment, vs. 15% at baseline.
  • 25% of patients developed new moderate diastolic dysfunction during treatment.

Sources:

  • Dynamic cardiac changes in low cardiovascular risk patients with triple negative breast cancer treated with chemo-immunotherapy. Cardio-Oncology, 2025,11(1):1-11.
  • Cardio-Oncology - https://cardiooncologyjournal.biomedcentral.com/
  • NewsRx. Research Reports from Cedars-Sinai Medical Center Provide New Insights into Breast Cancer (Dynamic cardiac changes in low cardiovascular risk patients with triple negative breast cancer treated with chemo-immunotherapy). Immunotherapy Weekly. September 3, 2025; p 631.