Trastuzumab in the treatment of metastatic breast cancer : anticancer therapy versus cardiotoxicity.
Trastuzumab, a monoclonal antibody against the HER2 receptor, was recently approved for the treatment of metastatic breast cancer. However, 28% of patients receiving both an anthracycline and trastuzumab developed heart failure. Although HER2 overexpression has been associated with the development of cancer, HER2 receptors seem to be cardioprotective because they mediate the activation of important cardiac survival pathways. Because the morbidity and mortality of heart failure surpasses that of many cancers, prudent medical practice mandates that physicians learn more about the mechanisms of trastuzumab-induced cardiotoxicity and develop algorithms for assessing risk/benefit ratios before extending the use of this agent to patients with less invasive forms of breast cancer.
Feldman
A M
AM
Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, PA 15213, USA. feldmanam@msx.upmc.edu
Lorell
B H
BH
Reis
S E
SE
D000911:Antibodies, Monoclonal / Q000506:poisoning* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000506:poisoning* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006801:Humans; D009362:Neoplasm Metastasis; D012307:Risk Factors; D000068878:Trastuzumab
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab