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Trastuzumab-induced cardiotoxicity.

Lisa Stegall Moss1, Mandy Fields Starbuck, Deborah K Mayer

  • 1Duke Health Systems, Duke Oncology Network, Durham, NC, USA. lisa.moss@duke.edu

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Trastuzumab can cause heart failure in about 4% of breast cancer patients. Early screening and monitoring for cardiovascular risk factors are crucial for safe treatment, especially for women with pre-existing heart conditions.

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Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Trastuzumab is a targeted therapy used in breast cancer treatment.
  • Cardiotoxicity is a known side effect of trastuzumab therapy.
  • Adjuvant breast cancer treatment involves monitoring for potential cardiac complications.

Purpose of the Study:

  • To review trastuzumab-related cardiotoxicity in breast cancer patients.
  • To present a system for screening cardiovascular risk factors before treatment.
  • To outline monitoring recommendations and discuss patient education.

Main Methods:

  • Literature review on trastuzumab and breast cancer cardiotoxicity.
  • Analysis of clinical trial data regarding cardiac events.
  • Evaluation of current screening and monitoring protocols.

Main Results:

  • Approximately 4% of patients in trials experienced heart failure.
  • Initial trials excluded patients with cardiac disease.
  • Current monitoring involves serial left ventricular function measurements (echocardiography/MUGA) every three months.
  • Treatment modifications are advised upon detecting changes from baseline.

Conclusions:

  • An increase in cardiotoxicity may occur as patients with pre-existing heart disease receive trastuzumab.
  • Guidelines and tools are needed for consistent screening and monitoring.
  • Nurses play a vital role in patient assessment, monitoring, and education regarding trastuzumab side effects.