Cardiotoxicity Profile of Trastuzumab

摘要: Trastuzumab is a monoclonal antibody that targets the human epidermal growth factor receptor tyrosine kinase HER2/ErbB2. This agent has shown highly significant antitumour effect for patients with HER2-positive breast cancer, and now considered part of standard regimens treatment this disease in both metastatic adjuvant setting. Cardiotoxicity been associated trastuzumab, issue studied documented number trials which data have released. to be potentiated when used concurrently or sequentially an anthracycline, limited use trastuzumab some patients. Determining overall impact further complicated by administration other cardiotoxic agents such as taxanes cyclophosphamide well pre-existing cardiac disease. The incidence severe congestive heart failure (New York Heart Association class III IV) was 0-3.9% arms versus 0-1.3% control five major randomized trials. Only one death related whereas two deaths occurred arms. Ejection fraction decline >or=10% 15% reported 3-34% recipients these Patients affected trastuzumab-related cardiotoxicity do not exhibit cellular distinctive ultrastructural myocardial changes seen on electron microscopy anthracycline-induced cardiotoxicity. also differs from traditional chemotherapy-induced it appears at least partially reversible, cumulative dose, re-challenge generally tolerated. There remain uncertainties regarding diagnosis management While no formal guidelines consensus statements exist present monitoring during proposed recommendations include careful assessment ejection prior initiating avoidance concurrent anthracyclines, regular symptoms function several years after therapy. Increased vigilance appropriate higher risk