Cardiotoxicity associated with trastuzumab (Herceptin) therapy in the treatment of metastatic breast cancer
Cardiotoxicity associated with trastuzumab (Herceptin) therapy in the treatment of metastatic breast cancer
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DOI：
10.1016/j.breast.2003.09.002
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发表时间：
2004-06-01
期刊：
影响因子：
3.9
通讯作者：
Barton, C
中科院分区：
文献类型：
--
作者：
Suter, TM;Cook-Bruns, N;Barton, C
曲妥珠单抗(Herceptin)是一种人源化的单抗，专门针对HER2阳性的乳腺癌细胞。从曲妥珠单抗的关键试验中收集的安全性数据表明，这种疗法通常耐受性良好。然而，曲妥珠单抗联合化疗的试验，特别是与蒽环类药物联合化疗的试验表明，一些患者的心脏毒性发生率增加，这在临床前或早期临床研究中并不明显。对现有数据的分析表明，在大多数情况下，观察到的心脏毒性可能反映了蒽环类药物引起的心脏毒性的加剧。目前已有多项研究对心脏毒性的生物学机制进行了研究，目前的数据表明Hereglin/HER2-信号通路可能起着重要作用。值得注意的是，心脏毒性通常是可逆的，通常可以通过标准的药物治疗来管理。继续曲妥珠单抗的患者和停止进一步治疗的患者的心功能都得到了改善，这表明通过谨慎的管理，抗癌治疗可以继续进行。(C)2003爱思唯尔有限公司。保留所有权利。
Trastuzumab (Herceptin) is a humanised monoclonal antibody that specifically targets HER2-positive breast cancer cells. Safety data collected from pivotal trials with trastuzumab indicate that this therapy is generally well tolerated. However trials of the combination of trastuzumab plus chemotherapy, and in particular chemotherapy with anthracyclines, have revealed an elevated incidence of cardiotoxicity in some patients, which was not apparent in preclinical or early clinical studies. Analyses of the available data suggest that in most cases the cardiotoxicity observed may reflect an exacerbation of anthracycline-induced cardiotoxicity. The biological mechanism of the cardiotoxicity has been investigated in several studies, and current data indicate that the heregulin/HER2-signalling pathway may have an important role. It is of note that the cardiotoxicity is generally reversible and can usually be managed with standard medical treatment. Improvement in cardiac function is seen both in patients who continue trastuzumab and in those in whom further therapy is withdrawn, indicating that with careful management anticancer therapy can be continued. (C) 2003 Elsevier Ltd. All rights reserved.