Abstract
Background
Chemotherapeutic agents directed against human epidermal growth factor receptor 2
(HER-2) have significantly improved the prognosis of patients who are positive for
this receptor. However, cardiomyopathy remains as a common adverse effect of using
these agents.
Materials and Methods
Literature search was conducted via PubMed using the keywords of “Trastuzumab Cardiomyopathy,”
“Lapatinib Cardiomyopathy” and “Pertuzumab Cardiomyopathy,” which provided 104 results.
These articles were then screened for relevance to the targeted subject based on their
title and abstracts. Case reports and articles that were not discussing any aspect
of cardiomyopathy secondary to targeted therapy for breast cancer and articles not
in English were eliminated. After elimination, a bibliography search among selected
articles was done and a total of 46 articles were identified. The collected articles
were then meticulously analyzed and summarized.
Results
The use of human epidermal growth factor receptor 2 (HER-2) receptor targeted chemotherapy
in breast cancer is limited because of a higher incidence (19–22%) of cardiomyopathy.
The incidence of cardiomyopathy is not dose dependent and in most cases it is reversible
after discontinuation of the drug and treatment with heart failure medications. Severe
adverse outcomes including death or permanent disability are rare.
Conclusion
HER-2 targeted chemotherapy for breast cancer has a higher incidence of associated
reversible cardiomyopathy. Patients should be monitored by serial echocardiography
starting at the beginning of the treatment and followed by every 3 months until the
completion of chemotherapy. Co-ordination between oncologists and cardiologists is
needed to develop evidence-based protocols to prevent, identify, monitor and treat
trastuzumab-induced cardiomyopathy.
Key Indexing Terms
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Article info
Publication history
Accepted:
September 22,
2015
Received:
May 21,
2015
Footnotes
The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
