title: Prolonged trastuzumab therapy in a patient with recurrent breast cancer and anthracycline-induced cardiac failure.
abstract: Current practice precludes patients with pre-existing cardiac dysfunction from trastuzumab therapy. A 57-year-old patient with HER2 positive metastatic breast cancer and anthracycline-induced cardiac failure was safely treated with trastuzumab. At 46 months, left ventricular ejection fraction (LVEF) did fall to 38.3%, but 8 months later has recovered to 47%. She remains disease free and asymptomatic from cardiac dysfunction more than 6 years following breast cancer recurrence. We review the evidence for the use of trastuzumab in patients with controlled cardiac dysfunction, and suggest this group of patients should be considered for treatment with trastuzumab if no other or only less efficacious therapeutic options are available.
authors.affiliation: The Cancer Centre, Queen Elizabeth Hospital, Vincent Drive, Birmingham B15 2TH, UK. nawaz.walji@uhb.nhs.uk
authors.forename: Nawaz
authors.initials: N
authors.lastname: Walji
authors.forename: Lubna
authors.initials: L
authors.lastname: Bhatt
authors.forename: Sindy
authors.initials: S
authors.lastname: Dhallu
authors.forename: Indrajit N
authors.initials: IN
authors.lastname: Fernando
mesh_terms: D018943:Anthracyclines / Q000009:adverse effects; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D000068878:Trastuzumab
chemical_list: D018943:Anthracyclines; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab