Abramson Cancer Center of The University of Pennsylvania, 1600 Penn Tower, Philadelphia, PA 19104, USA.
Prog Cardiovasc Dis. 2010 Sep-Oct;53(2):130-9. doi: 10.1016/j.pcad.2010.07.001.
Trastuzumab is the standard of care for the treatment of patients with ERB2-positive breast cancer. In a minority of patients, trastuzumab is associated with an increased incidence of cardiac dysfunction that ranges from asymptomatic decreases in left ventricular ejection fraction to symptomatic heart failure. In trials in the adjuvant setting, the difference in the incidence of cardiac events between the control and trastuzumab-containing arms was less than 4%. The baseline evaluation and oncologic setting (adjuvant versus metastatic disease) drive algorithms for the cardiac monitoring and management of these patients. When a patient develops documented left ventricular dysfunction, standard treatments for the management of heart failure should be prescribed. Trastuzumab cardiac dysfunction is an important clinical entity that can be managed effectively and individualized to maximize the cancer treatment benefit and minimize the risk and consequences of cardiac dysfunction.
曲妥珠单抗是 ERB2 阳性乳腺癌患者治疗的标准方案。在少数患者中，曲妥珠单抗与心脏功能障碍的发生率增加相关，从无症状的左心室射血分数降低到有症状的心衰。在辅助治疗的试验中，对照组和曲妥珠单抗组之间心脏事件的发生率差异小于 4%。基线评估和肿瘤学环境（辅助治疗与转移性疾病）推动了这些患者的心脏监测和管理算法。当患者出现有记录的左心室功能障碍时，应开出心力衰竭管理的标准治疗方案。曲妥珠单抗心脏功能障碍是一种重要的临床实体，可以进行有效的管理，并根据个体情况进行调整，以最大限度地提高癌症治疗效果，同时最小化心脏功能障碍的风险和后果。
