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Trastuzumab-Induced Cardiomyopathy

Rachel Barish1, Emily Gates2, Ana Barac3

  • 1MedStar Georgetown Physicians Group, Division of Cardiology, 3800 Reservoir Road Northwest 5PHC, Washington, DC 20007, USA.

Cardiology Clinics
|October 8, 2019
PubMed

Insights

Trastuzumab improves HER2-positive breast cancer outcomes but can cause heart failure. Monitoring cardiac function is crucial, with treatment adjustments recommended for left ventricular dysfunction.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Human epidermal growth factor receptor 2 (HER2) overexpression in 25% of breast cancers correlates with aggressive disease.
  • Trastuzumab is a targeted therapy significantly improving outcomes for HER2-positive breast cancer patients.
  • Trastuzumab therapy is linked to cardiotoxicity, including left ventricular dysfunction and heart failure.

Purpose of the Study:

  • To review the role of trastuzumab in cancer treatment.
  • To elucidate the mechanisms of trastuzumab-induced cardiotoxicity.
  • To discuss recent clinical findings and ongoing controversies regarding trastuzumab's cardiac effects.

Main Methods:

  • Literature review of trastuzumab's efficacy and cardiotoxicity.
  • Summary of clinical guidelines for cardiac monitoring during trastuzumab therapy.
  • Analysis of recent research on HER2-targeted therapy cardiotoxicity.

Main Results:

  • Trastuzumab offers substantial benefits in HER2-positive breast cancer.
  • Left ventricular dysfunction is a significant adverse effect requiring monitoring.
  • Recommendations include holding or stopping trastuzumab if cardiac dysfunction occurs.

Conclusions:

  • Trastuzumab is vital for HER2-positive breast cancer but necessitates careful cardiac surveillance.
  • Understanding and managing trastuzumab-induced cardiotoxicity is critical for patient safety.
  • Ongoing research addresses the balance between oncologic benefit and cardiac risk.
Keywords:
Breast cancerCardiooncologyCardiotoxicityGastric cancerHeart failureHuman epidermal growth factor 2 (HER2)

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