title: [Heart failure in women treated with adjuvant trastuzumab for breast cancer].
abstract: The amplification of the HER receptor system is present in approximately 20% of breast cancers and confers a marked malignancy and a poor prognosis. Trastuzumab, a monoclonal antibody directed against the HER2 receptor, has dramatically improved the prognosis of patients with HER2+ metastatic and early breast cancer. However, the use of trastuzumab is associated with the possible development of myocardial dysfunction and heart failure. Trastuzumab-induced cardiac injury may be reversible, and a substantial proportion of patients can complete therapy. For this reason, careful monitoring of cardiac function, an aggressive treatment of hypertension and possibly the use of non-anthracycline-containing chemotherapy protocols are required during trastuzumab treatment. Owing to the selection of patients enrolled in major randomized trials, the safety profile of trastuzumab is currently unclear in elderly women, in patients at high cardiovascular risk and in those with structural heart disease on optimal treatment. Further studies are therefore needed to determine whether this highly effective therapy in breast cancer survival can be extended to such categories of patients.
authors.affiliation: U.O. di Cardiologia, Ospedale San Martino, Belluno. gitarant@yahoo.com
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarantini
authors.forename: Mauro
authors.initials: M
authors.lastname: Feola
authors.forename: Adriana
authors.initials: A
authors.lastname: Albini
authors.forename: Stefania
authors.initials: S
authors.lastname: Gori
authors.forename: Jennifer
authors.initials: J
authors.lastname: Foglietta
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: Cicoira
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pulignano
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068878:Trastuzumab