Why the study?
Studies investigating the incidence of cardiotoxicity from concomitant trastuzumab and radiotherapy in HER2-positive breast cancer have reported conflicting results.
Does concurrent administration of trastuzumab and radiotherapy cause significant cardiac toxicity in HER2-positive breast cancer patients?
Does concurrent administration of trastuzumab and radiotherapy cause significant cardiac toxicity in HER2-positive breast cancer patients?
Concurrent radiotherapy with trastuzumab is clinically well-tolerated with a low prevalence of severe LVEF decline, though mild LVEF reduction is common.
Concomitant trastuzumab-radiotherapy yields mostly mild LVEF declines and remains well-tolerated; reinforces safety for HER2+ breast cancer while underscoring need for long-term cardiac surveillance.
Background and Aims Concomitant administration of trastuzumab (Tra) and radiotherapy (RT) has been known as an effective strategy for treating HER2‐positive breast cancer (HER2 + BC) patients. Studies have investigated the incidence of cardiotoxicity due to this concomitant treatment, but the results are conflicting. This systematic review and meta‐analysis study evaluated the cardiac toxicity occurrence in patients undergoing Tra + RT. Methods A systematic review was conducted on the databases of PubMed, WOS, and Scopus up to 2024. The decline in left ventricular ejection fraction (LVEF) from baseline was assessed as a cardiac toxicity indicator, LVEF reduction Grade 1 (LVEF 60%–50%), Grade 2 (LVEF 50%–40%), and Grade 3 (LVEF 40%–20%). Results Seven studies meeting defined criteria were included in this investigation. This study examined the prevalence of LVEF‐grade 1–3 in HER2 + BC patients undergoing concurrent treatment with Tra and RT. The combined results showed a prevalence of decreased LVEF in Grades 1–3 as 21.4%, 4%, and 1%, respectively, with statistical significance ( p < 0.05). Thus, among patients experiencing decreased LVEF, 70% were Grade 1, 25% were Grade 2, and 5% were Grade 3. Conclusion Cardiotoxic effects of chemotherapy and RT may accumulate and lead to heart failure so early diagnosis methods are advised. Concurrent RT with Tra is well‐tolerated clinically, and coadministration does not significantly raise primary cardiotoxicity. Cardiac toxicity may occur in some patients, requiring long‐term follow‐up to assess the impact of combining Tra and RT on heart function and its correlation with patient prognosis.
No takes yet. Share an insight, caveat, or question.
Jabbari et al. (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: