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

• Published in: Current oncology reports Vol. 23; no. 11; p. 128
• Main Authors: Dent, Susan F., Morse, Amber, Burnette, Sarah, Guha, Avirup, Moore, Heather
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2021; Springer Nature B.V
• Subjects: Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Cardio-oncology (EH Yang; Cardio-oncology (EH Yang, Section Editor); Cardiotoxicity; Cardiotoxicity - diagnosis; Cardiotoxicity - etiology; Clinical trials; Clinical Trials as Topic; ErbB-2 protein; Female; Heart; Humans; Immunoconjugates - adverse effects; Immunoconjugates - therapeutic use; Medicine; Medicine & Public Health; Molecular Targeted Therapy - adverse effects; Molecular Targeted Therapy - methods; Oncology; Patients; Protein Kinase Inhibitors - adverse effects; Protein Kinase Inhibitors - therapeutic use; Receptor, ErbB-2 - antagonists & inhibitors; Receptor, ErbB-2 - metabolism; Section Editor; Topical Collection on Cardio-oncology; Novel HER2 agents; Breast cancer; Cardiotoxicity; Cardiac monitoring
• ISSN: 1523-3790; 1534-6269
• DOI: 10.1007/s11912-021-01114-x

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. Summary 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.