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

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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.

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Conflict of interest statement

No funds were received in support of this study. No benefits of any kind were or will be received from a commercial party directly or indirectly related to the subject of this article.

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Authors and Affiliations

  1. Jules Bordet Institute, Brussels, Belgium

    Evandro de Azambuja, Philippe L. Bedard & Martine Piccart-Gebhart

  2. Université Libre de Bruxelles (U.L.B), Brussels, Belgium

    Evandro de Azambuja & Martine Piccart-Gebhart

  3. Swiss Cardiovascular Center, University Hospital, Bern, Switzerland

    Thomas Suter

  4. Jules Bordet Institute, Boulevard de Waterloo, 125, 1000, Brussels, Belgium

    Martine Piccart-Gebhart

Authors
  1. Evandro de Azambuja
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  2. Philippe L. Bedard
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  4. Martine Piccart-Gebhart
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Correspondence to Martine Piccart-Gebhart.

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de Azambuja, E., Bedard, P.L., Suter, T. et al. Cardiac toxicity with anti-HER-2 therapies-what have we learned so far?. Targ Oncol 4, 77–88 (2009). https://doi.org/10.1007/s11523-009-0112-2

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  • DOI: https://doi.org/10.1007/s11523-009-0112-2

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