Management of trastuzumab-related cardiac dysfunction.
Trastuzumab is the standard of care for the treatment of patients with ERB2-positive breast cancer. In a minority of patients, trastuzumab is associated with an increased incidence of cardiac dysfunction that ranges from asymptomatic decreases in left ventricular ejection fraction to symptomatic heart failure. In trials in the adjuvant setting, the difference in the incidence of cardiac events between the control and trastuzumab-containing arms was less than 4%. The baseline evaluation and oncologic setting (adjuvant versus metastatic disease) drive algorithms for the cardiac monitoring and management of these patients. When a patient develops documented left ventricular dysfunction, standard treatments for the management of heart failure should be prescribed. Trastuzumab cardiac dysfunction is an important clinical entity that can be managed effectively and individualized to maximize the cancer treatment benefit and minimize the risk and consequences of cardiac dysfunction.
Carver
Joseph R
JR
Abramson Cancer Center of The University of Pennsylvania, 1600 Penn Tower, Philadelphia, PA 19104, USA. jrc@mail.med.upenn.edu
D000818:Animals; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D018570:Risk Assessment; D000068878:Trastuzumab; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left / Q000187:drug effects
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab