Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
January 1, 2009The Oncologist

Minimizing Cardiotoxicity While Optimizing Treatment Efficacy with Trastuzumab: Review and Expert Recommendations

View Full Paper
Ask AI
Bookmark
Share

Why the study?

How can cardiotoxicity be minimized while optimizing treatment efficacy with trastuzumab in women with breast cancer?

Population

Women with breast cancer receiving trastuzumab

Design

Review

Authors

MMMiguel MartínHospital General Universitario Gregorio MarañónFEFrancisco J. EstevaNorthwell HealthEAEmilio AlbaHospital Clínico Universitario Virgen de la Victoria

Discussion

Loading...

Member takes

Implication

Supports avoiding concomitant anthracyclines with trastuzumab and routine LVEF monitoring; leaves open prospective validation of reversibility and optimal re-challenge protocols.

Key Points

  • To review the incidence, risk factors, and management strategies for trastuzumab-associated cardiotoxicity while maintaining effective antitumor therapy in breast cancer patients.
  • Narrative review of clinical trials evaluating trastuzumab efficacy, cardiac safety profiles, and combination treatment regimens in breast cancer.
  • Synthesis of expert recommendations regarding pre-treatment cardiac risk assessment, routine monitoring protocols, and heart failure interventions.
  • Trastuzumab-related cardiotoxicity presents primarily as asymptomatic left ventricular ejection fraction (LVEF) declines and less frequently as congestive heart failure (CHF).
  • Concomitant anthracycline administration significantly increases cardiotoxic risk, rendering simultaneous combination therapy non-recommended.
  • Cardiac dysfunction is typically reversible following trastuzumab discontinuation and CHF therapy, permitting treatment reintroduction after cardiac function resolves or when oncologic benefits exceed risks.

Structured PICO

How can cardiotoxicity be minimized while optimizing treatment efficacy with trastuzumab in women with breast cancer?

P
Population
Women with breast cancer receiving trastuzumab
I
Intervention
Trastuzumab therapy with cardiac monitoring and management
O
Outcome
Trastuzumab-associated cardiotoxicity (asymptomatic reduction in left ventricular ejection fraction or congestive heart failure)safety

Trastuzumab-associated cardiotoxicity is generally reversible, and risk can be minimized by avoiding concomitant anthracyclines and performing regular cardiac monitoring.

Cite This Study

Martín et al. (2009) studied this question.

synapsesocial.com/papers/6a7b628ea51ded8e7b331f7dhttps://doi.org/10.1634/theoncologist.2008-0137
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult2005 · 2,256 citations
  2. 2Comparison of left ventricular ejection fraction and volumes in heart failure by echocardiography, radionuclide ventriculography and cardiovascular magnetic resonance. Are they interchangeable?2000 · 1,054 citations
  3. 3Human Breast Cancer: Correlation of Relapse and Survival with Amplification of the HER-2/ neu Oncogene1987 · 11,840 citations
  4. 4Guidelines for the diagnosis and treatment of chronic heart failure: executive summary (update 2005)2005 · 2,271 citations
  5. 5Adjuvant trastuzumab in the treatment of her-2-positive early breast cancer: a meta-analysis of published randomized trials2007 · 381 citations