Cardiac toxicity with anti-HER-2 therapies: what have we learned so far?

Evandro de Azambuja; Philippe L Bedard; Thomas Suter; Martine Piccart-Gebhart

doi:10.1007/s11523-009-0112-2

Cardiac toxicity with anti-HER-2 therapies: what have we learned so far?

Target Oncol. 2009 Apr;4(2):77-88. doi: 10.1007/s11523-009-0112-2. Epub 2009 May 6.

Authors

Evandro de Azambuja¹, Philippe L Bedard, Thomas Suter, Martine Piccart-Gebhart

Affiliation

¹ Jules Bordet Institute, Brussels, Belgium.

PMID: 19418111
DOI: 10.1007/s11523-009-0112-2

Abstract

Trastuzumab, a monoclonal antibody that blocks HER-2 receptor, improves the survival of women with HER-2-positive early and advanced breast cancer when given with chemotherapy. Lapatinib, a dual tyrosine kinase inhibitor of EGFR and HER-2, is approved for the treatment of metastatic breast cancer patients after failure of prior anthracycline, taxanes and trastuzumab therapies in combination with capecitabine. Importantly, cardiac toxicity, manifested as symptomatic congestive heart failure or asymptomatic left ventricular ejection fraction decline, has been reported in some of the patients receiving these novel anti-HER-2 therapies, particularly when these drugs are used following anthracyclines, whose cardiotoxic potential has been recognized for decades. This review will focus on the incidence, natural history, underlying mechanisms, management, and areas of uncertainty regarding trastuzumab-and lapatinib-induced cardiotoxicity.

Publication types

Review

MeSH terms

Adjuvants, Immunologic / administration & dosage
Anthracyclines / administration & dosage
Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal / adverse effects*
Antibodies, Monoclonal, Humanized
Breast Neoplasms / immunology
Breast Neoplasms / mortality
Breast Neoplasms / pathology
Breast Neoplasms / physiopathology
Breast Neoplasms / therapy*
Drug Resistance, Neoplasm
ErbB Receptors / antagonists & inhibitors*
Female
Heart Failure / chemically induced
Humans
Lapatinib
Oxidative Stress
Protein Kinase Inhibitors / administration & dosage
Protein Kinase Inhibitors / adverse effects
Quinazolines / administration & dosage
Quinazolines / adverse effects*
Receptor, ErbB-2 / antagonists & inhibitors*
Receptor, ErbB-2 / immunology
Survival Rate
Trastuzumab
Ventricular Outflow Obstruction / chemically induced

Substances

Adjuvants, Immunologic
Anthracyclines
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Protein Kinase Inhibitors
Quinazolines
Lapatinib
ERBB2 protein, human
ErbB Receptors
Receptor, ErbB-2
Trastuzumab