Liu Yong-Zhi, Jiang Hai, Zhao Yong-Hua, Zhang Qi, Hao Shi-Chao, Bao Li-Ping, Wu Wei, Jia Zhao-Bo, Jiang Hui-Chuan
Department of Breast Surgery, General Hospital of Benxi Iron & Steel Industry Group of Liaoning Health Industry Group, Benxi 117000, Liaoning Province, China.
World J Clin Cases. 2022 Mar 16;10(8):2491-2496. doi: 10.12998/wjcc.v10.i8.2491.
Trastuzumab is a generally safe agent prescribed in the systemic treatment of breast cancer. Tinnitus is not a currently known adverse event related to trastuzumab. Here, we describe a rare case of severe tinnitus and a migraine headache induced by trastuzumab used for adjuvant therapy.
A 37-year-old woman was diagnosed with hormone receptor-positive and human epidermal growth factor receptor 2-positive breast cancer. After surgery, she was treated with four cycles of epirubicin and cyclophosphamide; she then received docetaxel and a loading dose of trastuzumab plus pertuzumab. Less than half an hour after trastuzumab infusion, the patient complained of severe tinnitus and left-sided migraine headache. Trastuzumab monotherapy was discontinued immediately, and symptoms disappeared after 10 min. Trastuzumab was readministered, and severe tinnitus and migraine headache recurred. Trastuzumab was stopped, and severe tinnitus diminished after 10 min. Pertuzumab and docetaxel therapy was then administered, and no adverse events were observed. Subsequent infusions of trastuzumab every three weeks did not show the same symptoms.
Although trastuzumab is well-tolerated in most patients, we should pay attention to the risk of severe tinnitus and migraine.
曲妥珠单抗是一种常用于乳腺癌全身治疗的安全性良好的药物。耳鸣并非目前已知的与曲妥珠单抗相关的不良事件。在此，我们描述一例因辅助治疗使用曲妥珠单抗引发严重耳鸣和偏头痛的罕见病例。
一名37岁女性被诊断为激素受体阳性和人表皮生长因子受体2阳性乳腺癌。术后，她接受了四个周期的表柔比星和环磷酰胺治疗；随后接受多西他赛以及曲妥珠单抗加帕妥珠单抗的负荷剂量治疗。曲妥珠单抗输注后不到半小时，患者主诉严重耳鸣和左侧偏头痛。立即停用曲妥珠单抗单药治疗，10分钟后症状消失。再次给予曲妥珠单抗，严重耳鸣和偏头痛复发。停用曲妥珠单抗，10分钟后严重耳鸣减轻。随后给予帕妥珠单抗和多西他赛治疗，未观察到不良事件。此后每三周输注曲妥珠单抗未出现相同症状。
尽管大多数患者对曲妥珠单抗耐受性良好，但我们应注意严重耳鸣和偏头痛的风险。
