Targeted therapies in breast cancer: are heart and vessels also being targeted?
The concept of 'targeted' therapies implies that such drugs only act on cells that specifically express the particular target, therefore giving rise to a low incidence of side effects. However, targeted therapies currently approved for the treatment of breast cancer have demonstrated a relatively high incidence of cardiovascular events. The anti-HER2 agents trastuzumab and lapatinib may cause left ventricular dysfunction or even congestive heart failure. Bevacizumab, an antiangiogenic drug, has been shown to increase the risk of hypertension, cardiovascular dysfunction and thromboembolic events. In addition, several anti-human epidermal growth factor receptor 2 (HER2) and antiangiogenic agents plus their combinations are currently being developed and evaluated for the treatment of breast cancer. In this review, we aim to assess the incidence of cardiac adverse events associated with targeted therapies designed to block HER2 and angiogenic pathways.
Department of Medical Oncology, Jules Bordet Institute, Université Libre de Bruxelles, 1000 Brussels, Belgium. joelle.masina@bordet.be
Carmen
C
Criscitiello
Otto
O
Metzger-Filho
Kamal S
KS
Saini
Gilberto
G
de Castro
Marie
M
Diaz
André
A
La Gerche
Evandro
E
de Azambuja
Martine J
MJ
Piccart-Gebhart
D020533:Angiogenesis Inhibitors / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D000077341:Lapatinib; D058990:Molecular Targeted Therapy / Q000009:adverse effects*; D011799:Quinazolines / Q000009:adverse effects; D000068878:Trastuzumab; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced*
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D011799:Quinazolines; D000077341:Lapatinib; D000068258:Bevacizumab; D000068878:Trastuzumab