MedStar Georgetown Physicians Group, Division of Cardiology, 3800 Reservoir Road Northwest 5PHC, Washington, DC 20007, USA.
MedStar Heart and Vascular Institute, Georgetown University, 3800 Reservoir Road Northwest 5PHC, Washington, DC 20007, USA.
Cardiol Clin. 2019 Nov;37(4):407-418. doi: 10.1016/j.ccl.2019.07.005. Epub 2019 Aug 27.
Trastuzumab targets the human epidermal growth factor receptor 2 (HER2). Its overexpression occurs in 25% of breast cancers and is associated with aggressive tumor characteristics and poor prognosis in absence of targeted therapy. Trastuzumab dramatically improves HER2-positive breast cancer outcomes; however, its clinical use is associated with left ventricular dysfunction and heart failure. Patients receiving trastuzumab or other HER2-targeted therapies undergo routine cardiac function assessment. Holding and/or stopping trastuzumab treatment in the setting of left ventricular dysfunction is recommended. This article summarizes the role of trastuzumab in cancer treatment, the mechanisms of trastuzumab-induced cardiotoxicity, recent clinical investigations, and current controversies.
曲妥珠单抗靶向人表皮生长因子受体 2（HER2）。在 25%的乳腺癌中会出现其过度表达，并且在没有靶向治疗的情况下与侵袭性肿瘤特征和不良预后相关。曲妥珠单抗显著改善了 HER2 阳性乳腺癌的预后；然而，其临床应用与左心室功能障碍和心力衰竭相关。接受曲妥珠单抗或其他 HER2 靶向治疗的患者会进行常规心脏功能评估。建议在出现左心室功能障碍的情况下暂停或停止曲妥珠单抗治疗。本文总结了曲妥珠单抗在癌症治疗中的作用、曲妥珠单抗引起的心脏毒性的机制、最近的临床研究和当前的争议。
