Departments of Medicine, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Departments of Oncology, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Oncologist. 2019 Nov;24(11):1405-1409. doi: 10.1634/theoncologist.2019-0263. Epub 2019 Jul 17.
Trastuzumab is an effective treatment for HER2-positive breast cancer. Current guidelines recommend withholding trastuzumab in patients experiencing a significant asymptomatic decline in left ventricular function. In this commentary, we discuss the survival benefits afforded by trastuzumab juxtaposed against the risk of trastuzumab-mediated cardiotoxicity. It is not known whether the net benefit of continuing trastuzumab in the setting of mild cardiotoxicity outweighs the associated risks. We describe a potential approach undertaken by our group, and others, and call for a randomized trial.
曲妥珠单抗是治疗 HER2 阳性乳腺癌的有效方法。目前的指南建议在左心室功能出现显著无症状下降的患者中停用曲妥珠单抗。在这篇评论中，我们讨论了曲妥珠单抗带来的生存获益与曲妥珠单抗介导的心脏毒性风险。目前尚不清楚在轻度心脏毒性的情况下继续使用曲妥珠单抗的净获益是否超过相关风险。我们描述了我们小组和其他小组采取的一种潜在方法，并呼吁进行一项随机试验。
