title: Breast cancer therapy and cardiovascular risk: focus on trastuzumab.
abstract: Breast cancer is the most common cancer in the UK. Advances in the methods of early diagnosis as well as newer and more effective treatments have led to improvements of disease-free and overall survival over the last decade. Almost one-third of breast cancers present with an aggressive form characterized by increased expression of human epidermal growth receptor 2 (HER2) proteins. A targeted treatment using monoclonal antibodies against HER2 expression such as trastuzumab has been shown to improve survival. Unfortunately, there is a degree of cardiotoxicity associated with these agents, as inhibition of HER2 pathways can also impair cardioprotective pathways. In the present review, we discuss the mechanisms by which trastuzumab might affect vascular homeostasis leading to endothelial dysfunction. We also provide suggestions for future research examining the effects of trastuzumab on the vasculature in breast cancer.
authors.affiliation: School of Sport, Health and Exercise Sciences, Bangor University, Bangor, Wales, UK ; Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.
authors.forename: Aamer
authors.initials: A
authors.lastname: Sandoo
authors.affiliation: Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.
authors.forename: George D
authors.initials: GD
authors.lastname: Kitas
authors.affiliation: Dudley Group of Hospitals NHS Trust, Russells Hall Hospital, Dudley, UK.
authors.forename: Amtul R
authors.initials: AR
authors.lastname: Carmichael
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D004730:Endothelium, Vascular / Q000187:drug effects*; D018734:Genes, erbB-2 / Q000187:drug effects; D006333:Heart Failure / Q000139:chemically induced / Q000503:physiopathology; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects; D017382:Reactive Oxygen Species; D000068878:Trastuzumab / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D017382:Reactive Oxygen Species; D000068878:Trastuzumab
keywords: congestive heart failure; endothelial dysfunction; macrovasculature; microvasculature