Trastuzumab-Induced Cardiomyopathy

Cardiol Clin. 2019 Nov;37(4):407-418. doi: 10.1016/j.ccl.2019.07.005. Epub 2019 Aug 27.

Abstract

Trastuzumab targets the human epidermal growth factor receptor 2 (HER2). Its overexpression occurs in 25% of breast cancers and is associated with aggressive tumor characteristics and poor prognosis in absence of targeted therapy. Trastuzumab dramatically improves HER2-positive breast cancer outcomes; however, its clinical use is associated with left ventricular dysfunction and heart failure. Patients receiving trastuzumab or other HER2-targeted therapies undergo routine cardiac function assessment. Holding and/or stopping trastuzumab treatment in the setting of left ventricular dysfunction is recommended. This article summarizes the role of trastuzumab in cancer treatment, the mechanisms of trastuzumab-induced cardiotoxicity, recent clinical investigations, and current controversies.

Keywords: Breast cancer; Cardiooncology; Cardiotoxicity; Gastric cancer; Heart failure; Human epidermal growth factor 2 (HER2).

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / adverse effects
  • Breast Neoplasms / drug therapy*
  • Cardiomyopathies / chemically induced*
  • Cardiomyopathies / epidemiology
  • Cardiotoxicity
  • Female
  • Global Health
  • Humans
  • Incidence
  • Trastuzumab / adverse effects*

Substances

  • Antineoplastic Agents, Immunological
  • Trastuzumab