This review highlights the pathophysiology and clinical challenges of detecting and managing trastuzumab-induced cardiotoxicity in breast cancer patients.
Heightens vigilance for trastuzumab cardiotoxicity in breast cancer; leaves optimal detection and management strategies open for prospective trials.
The antibody trastuzumab, targeted to inhibit the signalling of ErbB2, a tyrosine kinase receptor overexpressed in 20-30% of breast cancers, improves the prognosis in women affected by this tumour, but produces cardiotoxicity, since ErbB2 is also involved in myocardial homeostasis. In this review, we discuss the pathophysiology of trastuzumab cardiomyopathy and the complex interplay between ErbB2 inhibition and anthracyclines, and we focus on the actual challenges of detecting, monitoring, and managing trastuzumab cardiotoxicity: the research of new, sensitive markers of early trastuzumab toxicity, before the ejection fraction is reduced, is an active field of research.
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Tocchetti et al. (2012) studied this question.
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