de Azambuja Evandro, Bedard Philippe L, Suter Thomas, Piccart-Gebhart Martine
Jules Bordet Institute, Brussels, Belgium.
Target Oncol. 2009 Apr;4(2):77-88. doi: 10.1007/s11523-009-0112-2. Epub 2009 May 6.
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.
曲妥珠单抗是一种阻断HER-2受体的单克隆抗体，与化疗联合使用时可提高HER-2阳性早期和晚期乳腺癌女性的生存率。拉帕替尼是一种EGFR和HER-2的双靶点酪氨酸激酶抑制剂，被批准用于先前蒽环类药物、紫杉烷类药物及曲妥珠单抗联合治疗失败后的转移性乳腺癌患者，并与卡培他滨联合使用。重要的是，在一些接受这些新型抗HER-2治疗的患者中，已报告出现心脏毒性，表现为有症状的充血性心力衰竭或无症状的左心室射血分数下降，特别是当这些药物在已知具有心脏毒性数十年的蒽环类药物之后使用时。本综述将重点关注曲妥珠单抗和拉帕替尼所致心脏毒性的发生率、自然病程、潜在机制、管理以及存在不确定性的领域。
