This case highlights the rare possibility of long-term irreversible cardiotoxicity from trastuzumab even in patients without baseline cardiac risk factors.
Rare chronic HF after trastuzumab in high-risk patients warrants vigilance; leaves open optimal long-term surveillance protocols.
Trastuzumab improves clinical outcomes in patients with human epidermal growth factor receptor-2-positive breast cancer. However, cardiotoxicity is a potentially important concern, and the long-term cardiac effects of trastuzumab therapy remain unclear. Although reduction of cardiac function by trastuzumab is mostly reversible, some patients, especially those with cardiac risk factors, may rarely experience chronic heart failure or prolonged left ventricular ejection fraction reduction. There have been no detailed published analyses of patients with such unfavorable clinical courses. We report the rare case of a metastatic breast cancer in a woman without cardiac risk factors who experienced long-term irreversible cardiotoxicity after discontinuation of trastuzumab therapy.
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Tanaka et al. (2017) studied this question.
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