title: Trastuzumab use in breast cancer: clinical issues.
abstract: BACKGROUND
  Overexpression of the epidermal growth factor 2 HER2 in breast cancer tissue is associated with shorter survival. Trastuzumab, a monoclonal antibody against HER2, can induce tumor responses when given alone and enhances the effectiveness of several chemotherapeutic agents.
  
  
  METHODS
  The recent clinical data on outcomes regarding testing for HER2 overexpression and the tolerance, toxicity, and antitumor effects of trastuzumab are reviewed.
  
  
  RESULTS
  Trastuzumab use is indicated either alone or with chemotherapy only in patients with IHC 3+ or FISH+ test results and survival is prolonged in patients with metastatic disease. Cardiac toxicity differs from anthracycline cardiac toxicity and is often reversible.
  
  
  CONCLUSIONS
  The safety and efficacy profile of trastuzumab in patients with metastatic disease has led to large-scale testing of addition of the intervention in the adjuvant setting.
authors.affiliation: Interdisciplinary Oncology Program at the University of South Florida, Tampa, USA. horton@moffitt.usf.edu
authors.forename: John
authors.initials: J
authors.lastname: Horton
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000556:secondary; D017024:Chemotherapy, Adjuvant / Q000379:methods; D005260:Female; D018734:Genes, erbB-2 / Q000187:drug effects; D005820:Genetic Testing / Q000379:methods; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D000068878:Trastuzumab
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab