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Review
. 2021 Aug 27;23(11):128.
doi: 10.1007/s11912-021-01114-x.

Cardiovascular Toxicity of Novel HER2-Targeted Therapies in the Treatment of Breast Cancer

Susan F Dent  1 , Amber Morse  2 , Sarah Burnette  2 , Avirup Guha  3   4 , Heather Moore  2
Affiliations
Review

Cardiovascular Toxicity of Novel HER2-Targeted Therapies in the Treatment of Breast Cancer

Susan F Dent et al. Curr Oncol Rep. .

Abstract

Purpose of review: HER2-targeted therapies have led to improved clinical outcomes in early and advanced breast cancer (BC). We review the long-term cardiotoxicity of HER2-targeted therapy in early and advanced BC, our current knowledge of cardiotoxicity of novel HER2-targeted therapies, and propose a cardiac monitoring (CM) strategy for this population.

Recent findings: Long-term data from studies with HER2-targeted therapy in the adjuvant setting have failed to demonstrate an increase in cardiotoxicity over time, and rates of cardiotoxicity seen with novel HER2 agents remain low. Despite over a decade of experience with HER2-targeted therapy, CM in clinical practice is inconsistent in patients with early BC and almost non-existent in advanced BC. Long-term follow-up of clinical trials with HER2-targeted agents in early and advanced BC has failed to demonstrate increased rates of cardiotoxicity over time, attesting to the long-term safety of this class of drugs for the majority of patients, although the long-term cardiac safety of newer HER2 agents in the non-clinical trial setting is largely unknown. We propose CM incorporating clinical history, cardiac imaging, and biomarkers.

Keywords: Breast cancer; Cardiac monitoring; Cardiotoxicity; Novel HER2 agents.

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Conflict of interest statement

Susan F. Dent has received compensation from Seattle Genetics for participating on advisory boards. Amber Morse declares that she has no conflict of interest. Sarah E Burnette declares that she has no conflict of interest. Avirup Guha declares that he has no conflict of interest. Heather Moore has received compensation from AstraZeneca/Daiichi-Sankyo and Seattle Genetics for participating on advisory boards.

Figures

Fig. 1
Fig. 1
Mechanism of action for HER2-targeted agents. Created with BioRender.com
Fig. 2
Fig. 2
A—Current recommended cardiac monitoring for early-stage breast cancer patients on HER2-targeted therapy. B—Suggested cardiac monitoring for early-stage breast cancer patients on HER2-targeted therapy
See this image and copyright information in PMC

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