Engelsk titel: Cardiotoxic effects of trastuzumab
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Författare:
Hysing, Jan
;
Wist, Erik
Email: jan.hysing@sthf.no
Språk: Nor
Antal referenser: 25
Dokumenttyp:
Översikt
UI-nummer: 11111276
Sammanfattning
Background. Breast cancer with overexpression of HER2 receptor is an aggressive type of breast cancer with a poor prognosis. Trastuzumab (Herceptin) is a monoclonal antibody that binds to the HER2 receptor on the cell surface, blocking the signals that promote cell proliferation. Trastuzumab treatment in the form of adjuvant therapy has halved the risk of relapse and has improved the overall survival in metastatic breast cancer. However, when given alone or in combination with cardiotoxic chemotherapy, especially anthracyclines, trastuzumab may lead to congestive heart failure of varying severity.
Material and method. The article is a non-systematic review of articles from clinical trials and on recommendations by Norwegian and international expert panels.
Results. The combination of trastuzumab and anthracyclines was reported in an early phase III trial to cause heart failure in 27?% of the patients. More than ten years of research have revealed central cardiotoxicity mechanisms associated with trastuzumab. Risk factors have been identified and recommendations drawn up for patient monitoring and treatment. After application of these recommendations, the prevalence of heart failure development appears to have been reduced to about 5?%.
Interpretation. On balance, the favourable effects of trastuzumab are convincing, but cardiotoxicity is a significant challenge. All patients treated with trastuzumab must be monitored regularly.