Trastuzumab
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First report of Tako-Tsubo syndrome: case report A 50-year-old woman developed Tako-Tsubo syndrome following treatment with trastuzumab for invasive ductal carcinoma. The woman started receiving trastuzumab 6 mg/kg 3 weekly in addition to docetaxel and carboplatin for right-sided multifocal invasive ductal carcinoma; her baseline left ventricular ejection fraction was 54%. After receiving six cycles of docetaxel and carboplatin, trastuzumab 6 mg/kg 3 weekly was continued with radiotherapy. She experienced 30 minutes of intense crushing chest pain with sweating during her 11th trastuzumab infusion; increased troponin T values (0.15 pcg/ ml) and nausea were also noted. ECG revealed negative T waves on leads V1-3, I and aVL. After 7 days, coronary angiography revealed normal arteries; ventriculography showed systolic bulging at mid-left ventricle level with normal basal and apical contractions. These findings were consistent with ’reverse Tako-Tsubo’. No recurrences of pain were reported, and the woman’s left ventricular function recovered after 6 weeks with standard therapy. Author comment: "This is the first report of Tako-Tsubo syndrome related to trastuzumab". Khanji M, et al. Tako-Tsubo syndrome after trastuzumab - an unusual complication of chemotherapy for breast cancer. Clinical Oncology 25: 329, No. 5, May 2013. Available from: URL: http://dx.doi.org/10.1016/j.clon.2012.12.007 803095912 United Kingdom
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of Tako-Tsubo syndrome associated with trastuzumab. The WHO ADR database contained 5 reports of stress cardiomyopathy associated with trastuzumab.
0114-9954/13/1479-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
Reactions 23 Nov 2013 No. 1479
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