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Reversible and irreversible cardiac dysfunction associated with trastuzumab in breast cancer
Yee-Lu Tham1, Mario S Verani, Jenny Chang
1Breast Center at Baylor College of Medicine, Houston, TX 77030, USA.
Abstract:
One of the newest agents used in the treatment of breast cancer is trastuzumab (Herceptin), a new recombinant DNA-derived humanized monoclonal antibody against the proto-oncogene, HER-2/neu gene product. However, despite its proven clinical efficacy, serious adverse effects leading to trastuzumab-induced cardiomyopathy have been described in up to 27% of patients receiving combination therapy with anthracyclines. There has been little published on the clinical syndrome of trastuzumab-induced cardiomyopathy. We describe three cases, of both reversible and irreversible cardiomyopathy, associated with the use of this novel and effective agent in HER-2 overexpressing breast cancer.
Insights
Trastuzumab (Herceptin) treats HER-2 positive breast cancer but can cause serious heart problems, including cardiomyopathy, especially with anthracycline combination therapy. This study details three cases of trastuzumab-induced cardiomyopathy, highlighting its potential reversibility.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Trastuzumab (Herceptin) is a targeted therapy for HER-2 overexpressing breast cancer.
- Anthracycline combination therapy with trastuzumab is associated with significant cardiotoxicity.
- The clinical presentation of trastuzumab-induced cardiomyopathy requires further elucidation.
Observation:
- Three cases of breast cancer patients treated with trastuzumab are presented.
- Cardiomyopathy developed in patients receiving trastuzumab, particularly with combination therapy.
- Both reversible and irreversible forms of trastuzumab-induced cardiomyopathy were observed.
Findings:
- Trastuzumab-induced cardiomyopathy is a serious adverse effect associated with HER-2 targeted therapy.
- The incidence of cardiomyopathy can be as high as 27% in combination therapy regimens.
- Clinical manifestations of this cardiotoxicity vary, including reversible and irreversible conditions.
Implications:
- Early recognition and monitoring for cardiac dysfunction are crucial in patients receiving trastuzumab.
- Understanding the spectrum of trastuzumab-induced cardiomyopathy can guide clinical management.
- Further research is needed to optimize treatment strategies and mitigate cardiac risks in breast cancer patients.