Is trastuzumab a cardiotoxic?

Despite enforcement of stringent patient enrollment criteria, trastuzumab-based regimens are still regarded as significant cardiotoxicity risk, although the numbers of cardiotoxic events from recent clinical studies are less than reported in earlier trials.

What do you monitor with trastuzumab?

After completion of 1 year trastuzumab in the adjuvant setting, LVEF monitoring every 6 months for at least 2 years is recommended. If trastuzumab is withheld for significant LV cardiac dysfunction, cardiac monitoring should occur monthly.

How can chemotherapy related cardiotoxicity be detected?

MRI remains the gold standard for evaluating LV function, but it is expensive. Troponins are effective biomarkers for the early detection of cardiotoxicity; they can detect drug-induced cardiotoxicity in the earliest phase, before any reduction in LVEF.

How is cardiotoxicity diagnosed?

The most widely recognised diagnosis of cardiotoxicity is based on changes in left ventricular (LV) systolic function measured by a single method, usually left ventricular ejection fraction (LVEF), sometimes on a single occasion.

Is Herceptin cardiotoxicity reversible?

Although the main cardiotoxicity of trastuzumab is only an asymptomatic decline in LVEF and is mostly reversible with interruption of trastuzumab or cardiac medication, some patients, especially those with cardiac risk factors, may rarely experience chronic heart failure or prolonged LVEF reduction.

Why does Herceptin cause cardiotoxicity?

Cardiotoxicity of trastuzumab is considered to be the result of attenuated HER2-mediated signaling in the heart, culminating in decreased functionality of cardiac myocytes. HER2 appears to function as a compensatory mechanism acting against cardiac stress, such as anthracycline-induced cardiotoxicity.

Is Herceptin chemo or immunotherapy?

Herceptin is an intravenous drug that is part of a chemotherapy regimen that is used to prevent recurrence of breast cancer, and for the treatment breast cancer that has spread beyond the breast (metastasized). It belongs to a class of drugs called monoclonal antibodies.

How is cardiotoxicity treated?

The most common medications used for cardiotoxicity treatment include: Beta-blockers, which slow down a patient’s heart rate, lower a patient’s blood pressure and strengthen the heart muscle can reduce palpitations and arrhythmias, hypertension and heart failure.

How do you manage cardiotoxicity?

Some of the common drugs that are used to treat cardiotoxicity may include:

1. Dexrazoxane hydrochloride – May be used to prevent or reduce the occurrence and severity of heart damage (cardiomyopathy) caused by doxorubicin (Adriamycin®).
2. ACE inhibitors – These drugs work by opening, or dilating, your arteries.

What is cardiac toxicity?

Damage to the heart muscle by a toxin is called cardiac toxicity. Cardiac toxicity may cause arrhythmias (changes in heart rhythm) or it can develop into heart failure. Heart failure does not mean that your heart has stopped or is about to stop.

Does Herceptin lower immune system?

Does trastuzumab (Herceptin) affect the immune system? Having trastuzumab (Herceptin) could mean you’re more at risk of getting coronavirus or becoming very ill if you get it. The risk is likely to be higher if you’re having it with chemotherapy.

Does Herceptin cause long term heart damage?

Heart muscle damage and heart failure are potentially serious side effects of Herceptin. A small study has found that after 3 months of Herceptin treatment, nearly 58% of women had some loss of heart function.

Are there any adverse cardiotoxic events with trastuzumab?

CARDIOTOXIC EVENTS REPORTED IN CLINICAL TRIALS Early phase I and phase II clinical trials in which trastuzumab was used alone or in combination with cisplatin appear to be well tolerated and did not report any significant adverse cardiac events in the patients [9,10].

Are there any clinical trials for trastuzumab treatment?

A few trials have been conducted to assess whether early intervention reduces trastuzumab-associated cardiotoxicity, as measured on the basis of changes in the LV.

What are the mechanisms of action of trastuzumab?

Mechanisms of trastuzumab-mediated cardiotoxicity are still evolving. This review highlights novel discovery of DNA Topoisomerase II as a shared target for anthracycline and trastuzumab-induced cardiotoxicity and speculates on cardiac risks associated with trastuzumab and immune checkpoint-based therapies. TRASTUZUMAB AND MECHANISMS OF ACTION

Why are cardiac surveillance guidelines for trastuzumab-containing…?

This concern that LVEF decline would be an early and actionable surrogate for subsequent development of congestive heart failure (CHF) led to the design and implementation of specific eligibility criteria and LVEF surveillance guidelines for the pivotal randomized adjuvant trials. These guidelines were subsequently adopted as the standard of care.