What question did this study set out to answer?

To provide an updated assessment of the incidence, clinical course, mechanisms, and management of trastuzumab-induced cardiac dysfunction in HER2-positive breast cancer.

January 13, 2004Journal of Clinical Oncology

Clinical Cardiac Tolerability of Trastuzumab

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Why the study?

Does trastuzumab increase the risk of cardiac dysfunction in patients with breast cancer?

Population

Patients with advanced or earlier stages of breast cancer overexpressing or amplifying HER2

Design

Review

Authors

EPEdith A. PerezNational University of San Luis RRRichard J. RodehefferHeart Failure & Transplant

Discussion

Member takes

Implication

May warrant LVEF monitoring with trastuzumab-anthracycline regimens; leaves open optimal mitigation in contemporary non-anthracycline settings.

Key Points

To provide an updated assessment of the incidence, clinical course, mechanisms, and management of trastuzumab-induced cardiac dysfunction in HER2-positive breast cancer.
Synthesized data from pivotal trials and prospective clinical studies evaluating cardiac safety in advanced and early-stage HER2-overexpressing breast cancer.
Evaluated standardized cardiac monitoring protocols, ejection fraction surveillance, and patient selection criteria regarding pre-existing cardiovascular conditions and anthracycline exposure.
Trastuzumab increases the risk of cardiac dysfunction, presenting predominantly as asymptomatic reductions in ejection fraction with the greatest risk occurring during concurrent anthracycline administration.
Overt congestive heart failure occurs in a small subset of patients and demonstrates substantial reversibility and improvement following standard medical management.

Structured PICO

Does trastuzumab increase the risk of cardiac dysfunction in patients with breast cancer?

Population

Patients with advanced or earlier stages of breast cancer overexpressing or amplifying HER2

Intervention

Trastuzumab

Outcome

Incidence and natural history of trastuzumab-associated cardiac dysfunction (decreases in ejection fraction and congestive heart failure)safety

Trastuzumab therapy in breast cancer patients carries a risk of cardiotoxicity, primarily asymptomatic LVEF decline and occasionally reversible CHF, especially when combined with anthracyclines.

Limitations

More data are needed to help elucidate the pathophysiology of this syndrome

Cite This Study

Perez et al. (2004) studied this question.

synapsesocial.com/papers/69fbd6c6df6507d4845ddadf https://doi.org/10.1200/jco.2004.01.120

Topics

HFrEF treatment Heart failure

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Implication

May warrant LVEF monitoring with trastuzumab-anthracycline regimens; leaves open optimal mitigation in contemporary non-anthracycline settings.

Clinical Cardiac Tolerability of Trastuzumab

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

Clinical Cardiac Tolerability of Trastuzumab

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

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