Ito Mayuko, Horimoto Yoshiya, Sasaki Ritsuko, Miyazaki Sakiko, Orihata Gotaro, Saito Mitsue
Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan.
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Case Rep Oncol. 2021 Feb 23;14(1):62-66. doi: 10.1159/000513002. eCollection 2021 Jan-Apr.
Pertuzumab, a humanized antibody drug, has improved outcomes of patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, when administered in combination with trastuzumab and other chemotherapies. Cardiotoxicity due to trastuzumab is widely recognized, while data on pertuzumab-based treatments in daily clinical practice are lacking. We herein report 2 Japanese patients, aged 72 and 49 years, who developed left ventricular dysfunction after pertuzumab administration, following long-term trastuzumab treatments. Both patients underwent curative surgery for their HER2-positive breast cancer and received anthracycline-based treatments. After developing metastatic disease, trastuzumab-based treatments were administered without cardiac toxicity, but both patients developed left ventricular dysfunction after pertuzumab administration (6 and 13 cycles, respectively). Although several large randomized trials have shown no additive effect of pertuzumab on cardiac dysfunction, careful monitoring of cardiac function appears to be necessary in daily practice, particularly for patients with prior long-term trastuzumab treatments.
帕妥珠单抗是一种人源化抗体药物，与曲妥珠单抗及其他化疗药物联合使用时，可改善人表皮生长因子受体2（HER2）阳性乳腺癌患者的预后。曲妥珠单抗所致的心脏毒性已得到广泛认可，但日常临床实践中关于基于帕妥珠单抗治疗的数据尚缺乏。我们在此报告2例日本患者，年龄分别为72岁和49岁，在长期接受曲妥珠单抗治疗后，使用帕妥珠单抗后出现左心室功能障碍。两名患者均接受了HER2阳性乳腺癌的根治性手术，并接受了基于蒽环类药物的治疗。出现转移性疾病后，给予基于曲妥珠单抗的治疗且无心脏毒性，但两名患者在使用帕妥珠单抗后均出现左心室功能障碍（分别为6个周期和13个周期）。尽管多项大型随机试验表明帕妥珠单抗对心脏功能障碍无叠加作用，但在日常实践中似乎仍有必要仔细监测心脏功能，尤其是对于既往长期接受曲妥珠单抗治疗的患者。
