Trastuzumab-Induced Cardiomyopathy: Incidence and Associated Risk Factors in an Inner-City Population

How does trastuzumab treatment affect the right ventricle in females with breast cancer?

“…Additionally, the authors revealed that LV ejection fraction and TAPSE were negatively correlated with the dosage of trastuzumab (8). Interestingly, the investigators did not find any significant difference in LV parameters (transmitral E/A and E/e’ ratios, LV Tei index, LV ejection fraction) before and after the treatment, as previous studies reported (4-6); furthermore, there was no difference in BNP, troponin, and CRP before and after trastuzumab therapy.…”

“…The same investigation showed that trastuzumab stimulates oxidative stress and apoptosis in the myocardium of mice and increases serum levels of cardiac troponin-I and cardiac myosin light chain-1 (3). All of these changes represent molecular mechanisms that could induce myocardial damage in terms of decreased left ventricular (LV) ejection fraction (4, 5), impaired LV mechanics (6), alteration of LV and atrial volumes, and LV systolic dysfunction in patients treated with trastuzumab (7). …”

Racial disparities in the rate of cardiotoxicity of HER2‐targeted therapies among women with early breast cancer

“…This was a retrospective study with a small sample size, although it was larger than some recent reports. 18,19 There were insufficient data on certain baseline patient characteristics, such as body mass index at the time of diagnosis, the number of years since diagnosis of hypertension and diabetes, and whether these medical conditions were well or poorly controlled. Data on symptomatic cardiac dysfunction were not collected.…”

“…17 Two smaller retrospective studies also have demonstrated that black patients have a higher risk of developing cardiotoxicity related to the receipt of HER2-targeted therapies. 18,19 We hypothesized that black patients with HER2-positive early breast cancer would have a higher probability of cardiotoxicity and an incomplete course of HER2-targeted therapy (incomplete therapy) than white patients. We designed a retrospective study to analyze the association of race with treatment-induced cardiotoxicity and receipt of incomplete therapy in patients with HER2positive early breast cancer.…”

Emerging therapies for breast cancer

“…It is the first antibody-drug conjugate (ADC) developed specifically for the treatment of HER2-positive breast cancer [131, 132]. The binding of T-DM1 to HER2-positive cells allows internalization of this complex by endocytosis, subsequent intralysosomal proteolytic degradation, and then release of potent DM1, a derivative of the antimitotic drug maytansine [133, 134]. …”