HER2 Positive Breast Cancer
- For early stage --> recommend surgery followed by adjuvant chemotherapy with a year of herceptin (trastuzumab)
- For advanced stage --> recommend neoadjuvant chemotherapy followed by surgery and a year of herceptin
- Cleopatra showed improved progression-free survival with combination of trastuzumab and pertuzumab
- Trastuzumab (Herceptin) --> inhibits HER2 receptor to prevent signal transduction
- Pertuzumab --> inhibits HER2 dimerization; works synergistically with herceptin
Posted 04/11/17 07:33:16 AM by Ying Liu
HER2 Targeted Agents and Cardiotoxicity
- Incidence is around 0.5-3% of patients treated with trastuzumab (higher if getting an anthracycline)
- Risk factors include age > 50, obesity and concurrent anthracycline administration. Concurrent radiation therapy does not increase risk
- Often manifests as a decreased in LVEF, usually asymptomatic but can cause clinical HF
- Unlike anthracyclines, cardiotoxicity is not related to cumulative dose
- Reversible with treatment discontinuation and rechallenge is often tolerated after cardiac recovery
- Mechanism is thought to be more myocyte “stunning” and loss of contractility
- Data on Pertuzumab is limited but suggests that it may be less cardiotoxic than trastuzumab
Posted 04/11/17 07:33:50 AM by Ying Liu
For further reading...
Posted 04/11/17 07:34:26 AM by Ying Liu
Created by Christopher Kelly
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