Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer

Somaira Nowsheen, Paul V. Viscuse, Ciara C. O’Sullivan, Nicole P. Sandhu, Tufia C Haddad, Anne Blaes, Jennifer Klemp, Lara Nhola, Joerg Herrmann, Kathryn J Ruddy

Research output: Contribution to journalReview article

4 Scopus citations

Abstract

Purpose of Review: Treatment with trastuzumab is a cornerstone of human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer treatment, but carries an unfortunate risk of toxicity to the cardiovascular system. Here, we review recent findings on trastuzumab-associated cardiotoxicity, focusing on its incidence, diagnosis, and treatment. Recent Findings: Screening with multigated acquisition scan (MUGA) or echocardiogram (ECHO) is recommended to assess cardiac function prior to and during trastuzumab therapy. Because trastuzumab-induced cardiotoxicity is typically reversible, cessation of trastuzumab and/or administration of first-line heart failure agents effectively restores cardiac function in most cases. Severe trastuzumab-induced cardiotoxicity is rare enough that the risk-benefit ratio still weighs in favor of its use in the vast majority of patients with HER2+ breast cancer. Summary: An improved understanding of the pathophysiology underlying trastuzumab-induced cardiotoxicity and the identification of patients at highest risk will allow us to continue to safely administer trastuzumab in patients with breast cancer.

Original languageEnglish (US)
Pages (from-to)173-182
Number of pages10
JournalCurrent Breast Cancer Reports
Volume9
Issue number3
DOIs
StatePublished - Sep 1 2017

Keywords

  • Breast cancer
  • Cardio-oncology
  • Cardiomyopathy
  • Cardiotoxicity
  • HER2
  • Trastuzumab

ASJC Scopus subject areas

  • Oncology

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