Trastuzumab
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Heart failure: case report A 45-year-old woman developed heart failure while receiving trastuzumab to treat breast cancer. The woman had been diagnosed with localised breast cancer 8 months prior to presenting to hospital with symptoms of heart failure; her cancer treatment included two cycles of 3-weekly trastuzumab (total dose 1000mg) [route not stated, time to reaction onset not clearly stated], in addition to other chemotherapy. Transthoracic echocardiogram (TTE) showed mild-to-moderate global left-ventricular systolic dysfunction. Heart failure was treated with carvedilol and furosemide; paclitaxel was discontinued and trastuzumab was temporarily withheld. Initial TTE showed a left-ventricular ejection fraction (LVEF) of 39%. Over the next 9 months, subsequent TTEs revealed a gradual improvement in the woman’s clinical status and cardiac function, and on the fourth visit, LVEF measured 52%. Due to the woman’s improved clinical status and LVEF, trastuzumab was restarted (carvedilol and furosemide were continued). A subsequent decline in left-ventricular systolic strain was noted, while LVEF was unchanged. Five months after trastuzumab was recommenced, an exercise stress test showed a further decrease in circumferential and longitudinal strain measurements, while LVEF was preserved. Author comment: "The improved cardiac function observed in this case after temporary cessation of trastuzumab indicates that the cardotoxicity was most likely due to trastuzumab". Stoodley P, et al. Trastuzumab-induced cardiotoxicity: The role of two-dimensional myocardial strain imaging in diagnosis and management. Echocardiography 29: E137-E140, No. 6, Jul 2012. Available from: URL: http://dx.doi.org/10.1111/ 803076544 j.1540-8175.2011.01645.x - Australia
0114-9954/10/1418-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 8 Sep 2012 No. 1418
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