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[Trastuzumab-associated cardiac dysfunction]

Yoshinobu Okada1, Chizuko Kanbayashi, Nobuaki Sato

  • 1Department of Internal Medicine, Niigata Cancer Center Hospital.

Gan to Kagaku Ryoho. Cancer & Chemotherapy
|April 24, 2010
PubMed

Insights

Trastuzumab chemotherapy can cause cardiac dysfunction in 4.7% of patients, often reversible upon drug withdrawal. Monitoring left ventricular ejection fraction (LVEF) is crucial during treatment.

Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Trastuzumab is a key therapy for HER2-positive cancers.
  • Cardiac dysfunction is a known, though infrequent, side effect of trastuzumab.
  • Early identification and management of cardiac events are vital for patient outcomes.

Purpose of the Study:

  • To determine the incidence of cardiac dysfunction in patients receiving trastuzumab-based chemotherapy.
  • To identify risk factors associated with trastuzumab-induced cardiotoxicity.
  • To recommend monitoring and management strategies for trastuzumab-related cardiac events.

Main Methods:

  • Retrospective analysis of 127 patients treated with trastuzumab-based chemotherapy.
  • Cardiac dysfunction defined by a specific decline in left ventricular ejection fraction (LVEF).
  • Patient history, baseline LVEF, and cardiac dimensions were analyzed for correlations.

Main Results:

  • Cardiac dysfunction occurred in 4.7% of patients (6 out of 127).
  • One patient experienced symptomatic heart failure; others were asymptomatic.
  • Recovery of cardiac function was observed in 4 out of 5 patients after trastuzumab withdrawal.
  • Risk factors included prior epirubicin/taxane use, lower baseline LVEF, and larger LV end-diastolic dimension.

Conclusions:

  • Trastuzumab-associated cardiac dysfunction is relatively uncommon but significant.
  • Regular echocardiography or radionuclide angiography is recommended before and during trastuzumab therapy.
  • Discontinuation of trastuzumab is advised for LVEF below 45% or congestive heart failure.

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