Document Detail


Minimizing cardiotoxicity while optimizing treatment efficacy with trastuzumab: review and expert recommendations.
MedLine Citation:
PMID:  19147689     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Numerous clinical studies have demonstrated the therapeutic benefit of trastuzumab in women with breast cancer. However, a small but not insignificant proportion of patients have experienced trastuzumab-associated cardiotoxicity during these trials. This phenomenon is generally characterized by an asymptomatic reduction in left ventricular ejection fraction (LVEF) or, less often, congestive heart failure (CHF). Concomitant anthracycline therapy significantly increases the risk for cardiotoxicity during trastuzumab treatment, and such regimens are therefore not recommended. The cardiac dysfunction associated with trastuzumab is most often reversible upon discontinuation of treatment and initiation of standard medical therapy for CHF. Prior to treatment initiation, a risk-benefit analysis should be performed for each individual patient, including a thorough assessment of potential risk factors and cardiac function. Cardiac monitoring should be continued throughout trastuzumab therapy and the follow-up period, because early recognition of trastuzumab-associated cardiac dysfunction can allow effective medical intervention. Following the occurrence of asymptomatic LVEF reduction or CHF and appropriate medical intervention, reintroduction of trastuzumab may be considered in patients following resolution of normal cardiac function, or in those for whom the benefit of antitumor therapy outweighs the risk for CHF.
Authors:
Miguel Martín; Francisco J Esteva; Emilio Alba; Bijoy Khandheria; Leopoldo Pérez-Isla; José Angel García-Sáenz; Antonia Márquez; Partho Sengupta; José Zamorano
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-01-15
Journal Detail:
Title:  The oncologist     Volume:  14     ISSN:  1549-490X     ISO Abbreviation:  Oncologist     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-06-25     Revised Date:  2013-05-08    
Medline Journal Info:
Nlm Unique ID:  9607837     Medline TA:  Oncologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-11     Citation Subset:  IM    
Affiliation:
Department of Medical Oncology, San Carlos University Hospital, Madrid, Spain. mmartin@geicam.org
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MeSH Terms
Descriptor/Qualifier:
Antibodies, Monoclonal / administration & dosage*,  adverse effects*
Antibodies, Monoclonal, Humanized
Antineoplastic Agents / administration & dosage*,  adverse effects*
Breast Neoplasms / drug therapy*
Female
Heart Diseases / chemically induced*
Humans
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Antibodies, Monoclonal, Humanized; 0/Antineoplastic Agents; P188ANX8CK/trastuzumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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