Key result
ErbB2-targeted drugs like trastuzumab link to cardiotoxicity presenting primarily as reversible LVEF decline.
Why the study?
HER2-targeted therapy causes cardiotoxicity whose mechanism is not fully understood, particularly when used with anthracyclines.
What are the mechanisms, clinical features, diagnostic strategies, and intervention strategies related to cardiotoxicity of ErbB2-targeting drugs in breast cancer?
What are the mechanisms, clinical features, diagnostic strategies, and intervention strategies related to cardiotoxicity of ErbB2-targeting drugs in breast cancer?
This review summarizes the mechanisms of HER2-targeted therapy-induced cardiotoxicity and highlights the potential of NT-proBNP for monitoring and cardioprotective drugs for intervention.
Breast cancer is the most common form of cancer in women and its incidence has been increasing over the years. Human epidermal growth factor receptor 2 (HER2 or ErbB2) overexpression is responsible for 20 to 25% of invasive breast cancers, and is associated with poor prognosis. HER2-targeted therapy has significantly improved overall survival rates in patients with HER2-positive breast cancer. However, despite the benefits of this therapy, its cardiotoxicity is a major concern, especially when HER2-targeted therapy is used in conjunction with anthracyclines. At present, the mechanism of this cardiotoxicity is not fully understood. It is thought that HER2-targeting drugs inhibit HER2/NRG 1 dimer formation, causing an increase in ROS in the mitochondria of cardiomyocytes and inhibiting the PI3K/Akt and Ras/MAPK pathways, resulting in cell apoptosis. Antioxidants, ACE inhibitors, angiotensin II receptor blockers, β-blockers, statins and other drugs may have a cardioprotective effect when used with ErbB2-targeting drugs. NT-proBNP can be used to monitor trastuzumab-induced cardiotoxicity during HER2-targeted treatment and may serve as a biological marker for clinical prediction of cardiotoxicity. Measuring NT-proBNP is non-invasive, inexpensive and reproducible, therefore is worthy of the attention of clinicians. The aim of this review is to discuss the potential mechanisms, clinical features, diagnostic strategies, and intervention strategies related to cardiotoxicity of ErbB2-targeting drugs.
No takes yet. Share an insight, caveat, or question.
Yang et al. (2021) conducted a review in HER2-positive breast cancer. ErbB2-targeted drugs was evaluated. ErbB2-targeted drugs for breast cancer, particularly trastuzumab, are associated with cardiotoxicity, primarily manifesting as a reversible decrease in left ventricular ejection fraction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: