(Circulation. 2000;102:272.)
© 2000 American Heart Association, Inc.
Editorial |
Trastuzumab in the Treatment of Metastatic Breast Cancer
Anticancer Therapy Versus Cardiotoxicity
From the Cardiovascular Institute of the University of Pittsburgh Medical Center Health System, Pittsburgh, Pa (A.M.F., S.E.R.), and the Cardiology Division of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass (B.H.L.).
Correspondence to Arthur M. Feldman, MD, PhD, Cardiovascular Institute, 200 Lothrop Street, S-572 Scaife Hall, Pittsburgh, PA 15213. E-mail feldmanam{at}msx.upmc.edu
Abstract
Abstract—Trastuzumab, a monoclonal antibody against the HER2 receptor, was recently approved for the treatment of metastatic breast cancer. However, 28% of patients receiving both an anthracycline and trastuzumab developed heart failure. Although HER2 overexpression has been associated with the development of cancer, HER2 receptors seem to be cardioprotective because they mediate the activation of important cardiac survival pathways. Because the morbidity and mortality of heart failure surpasses that of many cancers, prudent medical practice mandates that physicians learn more about the mechanisms of trastuzumab-induced cardiotoxicity and develop algorithms for assessing risk/benefit ratios before extending the use of this agent to patients with less invasive forms of breast cancer.
Key Words: heart failure • breast neoplasms • drug toxicity
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