[Protocol for administration of trastuzumab based on cardiac function].
We analyzed 7 patients with breast cancer who suffered from trastuzumab-associated cardiac dysfunction. Left ventricular ejection fraction (EF) was calculated by M-mode echocardiography. We propose a protocol for the administration of trastuzumab based on EF in the clinical courses of the 7 patients and the literatures concernig trastuzumab. If the EF is ≥60%, an echocardiography is performed every 3 months during trastuzumab therapy. If the EF is ≥53% and ≤60%, an echocardiography is performed every 2 months. If the EF is ≤53%, an echocardiography is performed more frequently. If the EF decreases by ≥10% from its previous level, an echocardiography is performed after 3 weeks. Also, trastuzumab is withheld when the EF falls to ≤45%. When the EF falls to ≤40%, the standard treatment for congestive heart failure is initiated. An echocardiography is performed every 2 weeks after trastuzumab is withheld. Trastuzumab therapy can be resumed if the EF improves to ≥50%.
Dept. of Internal Medicine, Niigata Cancer Center Hospital.
Yoshinobu
Y
Okada
Koji
K
Kaneko
Chizuko
C
Kanbayashi
Nobuaki
N
Sato
D000328:Adult; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D000068878:Trastuzumab; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000503:physiopathology
D061067:Antibodies, Monoclonal, Humanized; D000068878:Trastuzumab