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
Externally publishedYes

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Keywords

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

Cite this

Nowsheen, S., Viscuse, P. V., O’Sullivan, C. C., Sandhu, N. P., Haddad, T. C., Blaes, A., Klemp, J., Nhola, L., Herrmann, J., & Ruddy, K. J. (2017). Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer. Current Breast Cancer Reports, 9(3), 173-182. https://doi.org/10.1007/s12609-017-0249-4