Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer

Nowsheen, Somaira; Viscuse, Paul V.; O’Sullivan, Ciara C.; Sandhu, Nicole P.; Haddad, Tufia C.; Blaes, Anne; Klemp, Jennifer R.; Nhola, Lara F.; Herrmann, Joerg; Ruddy, Kathryn J.

doi:10.1007/s12609-017-0249-4

Cited by 34 publications

(24 citation statements)

References 87 publications

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“… 2 , 3 It is known that the highest rates of Trastuzumab induced cardiotoxicity are observed in patients receiving Trastuzumab after treatment with an anthracycline. 9 , 10 Although the anthracycline-containing treatment regimens remain superior with regard to both disease-free and overall survival in long-term follow-up, the differences are small and often weigh against the risk of cardiotoxicity. 6 The pathophysiology of the cardiotoxicity is always based on pro-oxidative, anti-metabolic and pro-inflammatory processes in cardiac tissues.…”

Section: Discussionmentioning

confidence: 99%

“…6 , 7 The monoclonal antibody Trastuzumab, also causes cardiotoxicity and hepatotoxicity in breast cancer patients. 8 , 9 Pooled data from randomized clinical trials estimate that Trastuzumab is associated with an absolute increase in HF incidence by 1.6% and abnormalities in left ventricular systolic function by 7.2% 10 which have been reported to be transient in some cases. However, the combined therapy of anthracyclines and anti-HER2 antibodies increases the incidence of cardiotoxicity; in fact, the cumulative incidence of cardiac events in women treated with anthracycline and Trastuzumab at 1 year after the diagnosis of breast cancer was 16.4%, at 2 years 23.8%, and at 3 years 28.2%.…”

Section: Introductionmentioning

confidence: 99%

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<p>Nano-Encapsulation of Coenzyme Q10 in Secondary and Tertiary Nano-Emulsions for Enhanced Cardioprotection and Hepatoprotection in Human Cardiomyocytes and Hepatocytes During Exposure to Anthracyclines and Trastuzumab</p>

Quagliariello¹,

Vecchione²,

Capua³

et al. 2020

IJN

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Introduction CoenzymeQ 10 (CoQ 10 ) is a well-known antioxidant and anti-inflammatory agent with cardioprotective properties. However, clinical trials based on its oral administration have failed to provide significant effect on cardiac functionality. The main limitation of CoQ 10 is based on its very low oral bioavailability and instability that limit dramatically its effects as a cardioprotective agent. Herein, we loaded CoQ 10 in high bioavailable nano-emulsions (NEs) coated with chitosan or chitosan and hyaluronic acid in order to improve its performance. Methods We tested cardioprotective and hepatoprotective effects of CoQ 10 -loaded nano-carriers against Doxorubicin and Trastuzumab toxicities in cardiomyocytes and liver cells through analysis of cell viability, lipid peroxidation, expression of leukotrienes, p65/NF-kB and pro-inflammatory cytokines involved in anticancer-induced cardio and hepatotoxicity. Results Nano-carriers showed high stability and loading ability and increased cell viability both in hepatocytes and cardiomyocytes during anticancer treatments. We observed that these effects are mediated by the inhibition of lipid peroxidation and reduction of the inflammation. CoQ 10 -loaded nano-emulsions showed also strong anti-inflammatory effects reducing leukotriene B4 and p65/NF-κB expression and Interleukin 1β and 6 production during anticancer treatments. Discussion Anthracyclines and Human epidermal growth factor receptor (HER2) inhibitors have shown significant anticancer effects in clinical practice but their use is characterized by cardiotoxicity and hepatotoxicity. Nano-carriers loaded with CoQ 10 showed cardio and hepatoprotective properties mediated by reduction of oxidative damages and pro-inflammatory mediators. These results set the stage for preclinical studies of cardio and hepatoprotection in HER2+ breast cancer-bearing mice treated with Doxorubicin and Trastuzumab.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

<p>Nano-Encapsulation of Coenzyme Q10 in Secondary and Tertiary Nano-Emulsions for Enhanced Cardioprotection and Hepatoprotection in Human Cardiomyocytes and Hepatocytes During Exposure to Anthracyclines and Trastuzumab</p>

Quagliariello¹,

Vecchione²,

Capua³

et al. 2020

IJN

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“…Trastuzumab, a monoclonal antibody against HER2-ErbB2, has been commonly used in HER2 (+) breast cancer. 25) 26) The cardiotoxic mechanism of this agent is mediated by inhibition of the ErbB2 receptor, which seems to play a major role in the cardiomyocyte proliferation and cardiac development required for cardiac contractility. Cardiotoxicity occurs more frequently when this agent is administered concurrently with anthracyclines.…”

Section: Introductionmentioning

confidence: 99%

“…Cardiotoxicity occurs more frequently when this agent is administered concurrently with anthracyclines. 25) 26) …”

Section: Introductionmentioning

confidence: 99%

Diagnosis, Treatment, and Prevention of Cardiovascular Toxicity Related to Anti-Cancer Treatment in Clinical Practice: An Opinion Paper from the Working Group on Cardio-Oncology of the Korean Society of Echocardiography

Kim

Chung

Cho

et al. 2018

J Cardiovasc Ultrasound

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Cardiovascular (CV) toxicity associated with anti-cancer treatment is commonly encountered and raises critical problems that often result in serious morbidity or mortality. Most cardiac toxicities are related to the cumulative dose of chemotherapy; however, the type of chemotherapy, concomitant agents, and/or conventional CV risk factors have been frequently implicated in CV toxicity. Approximately half of the patients exhibiting CV toxicity receive an anthracycline-based regimen. Therefore, serologic biomarkers or cardiac imagings are important during anti-cancer treatment for early detection and the decision of appropriate management of cardiotoxicity. However, given the difficulty in determining a causal relationship, a multidisciplinary collaborative approach between cardiologists and oncologists is required. In this review, we summarize the CV toxicity and focus on the role of cardiac imaging in management strategies for cardiotoxicity associated with anti-cancer treatment.

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“…As a result, doses of anthracycline such as doxorubicin have decreased. Trastuzumab, a biological therapy that targets the HER-2 receptor can lead to reversible congestive heart failure [5][6][7]. Tamoxifen used as an adjuvant therapy for breast cancer increases risk of venous thrombosis [2].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Disease among Breast Cancer Survivors

Majeed¹,

Ayyala²,

Kapuku³

et al. 2020

CDM

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Background: Among breast cancer survivors age > 50 years, deaths due to cardiovascular disease account for 35% of non-cancer related deaths. The increases in cardiovascular disease among breast cancer survivors is due to the cardiotoxic effects of breast cancer treatment and to overlapping risk factors for breast cancer and cardiovascular disease. Methods: We conducted a study of a sample of 164 breast cancer patients in order to examine the frequency of cardiovascular disease. The overall objective was to examine the frequency of high blood pressure, myocardial infarction, cardiomyopathy, congestive heart failure, stroke, and venous thrombosis/thromboembolism among women who have been diagnosed with stage I-IV breast cancer and who had completed primary therapy for the disease. Data were collected by postal survey and abstraction of electronic medical records. Results: A high percentage of the women (62.8%) had a reported history of high blood pressure. Fifty percent of the women had a reported history of high cholesterol. About 8.3% of the women were current smokers and 36.0% were former smokers. About 23.8% of the women had a reported history of diabetes. About 4.9% of the women had a reported history of congestive heart failure and 6.1% had a history of stroke. Discussion: Additional studies are needed of cardiovascular risk factors and adverse cardiovascular events among breast cancer survivors. Of particular concern is whether patients with hypertension, hypercholesterolemia, and diabetes are receiving appropriate therapy to reduce their cardiovascular risk and prevent morbidity and mortality from adverse cardiovascular events.

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Incidence, Diagnosis, and Treatment of Cardiac Toxicity From Trastuzumab in Patients With Breast Cancer

Cited by 34 publications

References 87 publications

<p>Nano-Encapsulation of Coenzyme Q10 in Secondary and Tertiary Nano-Emulsions for Enhanced Cardioprotection and Hepatoprotection in Human Cardiomyocytes and Hepatocytes During Exposure to Anthracyclines and Trastuzumab</p>

<p>Nano-Encapsulation of Coenzyme Q10 in Secondary and Tertiary Nano-Emulsions for Enhanced Cardioprotection and Hepatoprotection in Human Cardiomyocytes and Hepatocytes During Exposure to Anthracyclines and Trastuzumab</p>

Diagnosis, Treatment, and Prevention of Cardiovascular Toxicity Related to Anti-Cancer Treatment in Clinical Practice: An Opinion Paper from the Working Group on Cardio-Oncology of the Korean Society of Echocardiography

Cardiovascular Disease among Breast Cancer Survivors

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