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Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer

  • Clinical Trials (PF Peddi, Section Editor)
  • Published:
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Abstract

Purpose of Review

Treatment with trastuzumab is a cornerstone of human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer treatment, but carries an unfortunate risk of toxicity to the cardiovascular system. Here, we review recent findings on trastuzumab-associated cardiotoxicity, focusing on its incidence, diagnosis, and treatment.

Recent Findings

Screening with multigated acquisition scan (MUGA) or echocardiogram (ECHO) is recommended to assess cardiac function prior to and during trastuzumab therapy. Because trastuzumab-induced cardiotoxicity is typically reversible, cessation of trastuzumab and/or administration of first-line heart failure agents effectively restores cardiac function in most cases. Severe trastuzumab-induced cardiotoxicity is rare enough that the risk-benefit ratio still weighs in favor of its use in the vast majority of patients with HER2+ breast cancer.

Summary

An improved understanding of the pathophysiology underlying trastuzumab-induced cardiotoxicity and the identification of patients at highest risk will allow us to continue to safely administer trastuzumab in patients with breast cancer.

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Authors and Affiliations

  1. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, MN, USA

    Somaira Nowsheen

  2. Department of Medicine, Mayo Clinic, Rochester, MN, USA

    Paul V Viscuse

  3. Division of Medical Oncology, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA

    Ciara C. O’Sullivan, Tufia C. Haddad & Kathryn J. Ruddy

  4. Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Nicole P. Sandhu

  5. Department of Medicine, University of Minnesota, Rochester, MN, USA

    Anne Blaes

  6. Division of Clinical Oncology, University of Kansas Medical Center, Wichita, KS, USA

    Jennifer Klemp

  7. Division of Cardiology Research, Mayo Clinic, Rochester, MN, USA

    Lara Nhola

  8. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA

    Joerg Herrmann

Authors
  1. Somaira Nowsheen
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  2. Paul V Viscuse
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  3. Ciara C. O’Sullivan
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  4. Nicole P. Sandhu
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  5. Tufia C. Haddad
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  6. Anne Blaes
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  7. Jennifer Klemp
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  8. Lara Nhola
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  9. Joerg Herrmann
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  10. Kathryn J. Ruddy
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Corresponding author

Correspondence to Kathryn J. Ruddy.

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Conflict of Interest

The authors declare that they have no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Source of Funding

K.J.R. was supported by a training grant under the CTSA Grant Program Numbers UL1 TR000135 and KL2TR000136-09 from the National Center for Advancing Translational Sciences (NCATS) of the NIH. The contents of this paper are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

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This article is part of the Topical Collection on Clinical Trials

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Nowsheen, S., Viscuse, P.V., O’Sullivan, C.C. et al. Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer. Curr Breast Cancer Rep 9, 173–182 (2017). https://doi.org/10.1007/s12609-017-0249-4

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  • DOI: https://doi.org/10.1007/s12609-017-0249-4

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