Does trastuzumab require cardiac monitoring?

Does trastuzumab require cardiac monitoring?

After completion of 1 year trastuzumab in the adjuvant setting, LVEF monitoring every 6 months for at least 2 years is recommended. If trastuzumab is withheld for significant LV cardiac dysfunction, cardiac monitoring should occur monthly.

What do you monitor with trastuzumab?

Does Herceptin cause cardiotoxicity?

Similarly, final analysis from HERceptin Adjuvant trial also reported much lower rate of cardiotoxicity with 7.25% incidence of secondary cardiac endpoint (class I or II toxicity as defined by New York Heart Association) in 2-year trastuzumab group and 4.4% in 1-year trastuzumab [16].

What to check before giving trastuzumab?

Your doctor may check your heart function before you may take any Trastuzumab and will monitor your heart closely during your treatment….The frequency of side effects reported is based on single agent Trastuzumab:

1. Headache.
2. Diarrhea.
3. Abdominal pain.
4. Back pain.
5. Infection.
6. Flu-like symptoms.
7. Vomiting.
8. Cough.

What is a MUGA scan used for?

A MUGA scan creates a video of the blood pumping through the lower chambers, or ventricles, of the heart. This shows if there are problems with the way the heart is pumping and blood flow. A MUGA scan is often done before a person starts cancer treatment.

Is trastuzumab cardiotoxicity reversible?

Although the main cardiotoxicity of trastuzumab is only an asymptomatic decline in LVEF and is mostly reversible with interruption of trastuzumab or cardiac medication, some patients, especially those with cardiac risk factors, may rarely experience chronic heart failure or prolonged LVEF reduction.

Why do anthracyclines cause cardiotoxicity?

Anthracycline-induced cardiotoxicity is due in large part to the generation of free radicals from doxorubicin through mitochondrial redox cycling of doxorubicin in the cardiomyocyte, which ultimately results in left ventricular dysfunction, and in the most severe cases, congestive heart failure.

Can cardiotoxicity be reversed?

Type I cardiotoxicity is caused by cardiomyocyte death, either through necrosis or apoptosis, and as a result is not reversible. Type II cardiotoxicity is caused by cardiomyocyte dysfunction rather than cell death and therefore may be reversible.

Do you dilute trastuzumab?

Using a sterile syringe, slowly inject the 20 mL of diluent into the vial containing the lyophilized cake of Herceptin. The stream of diluent should be directed into the lyophilized cake. Swirl the vial gently to aid reconstitution. DO NOT SHAKE.

What is the MOA of trastuzumab?

Mechanism of Action of Trastuzumab Trastuzumab consists of two antigen-specific sites that bind to the juxtamembrane portion of the extracellular domain of the HER2 receptor and that prevent the activation of its intracellular tyrosine kinase.

Are there any adverse cardiotoxic events with trastuzumab?

CARDIOTOXIC EVENTS REPORTED IN CLINICAL TRIALS Early phase I and phase II clinical trials in which trastuzumab was used alone or in combination with cisplatin appear to be well tolerated and did not report any significant adverse cardiac events in the patients [9,10].

How to monitor left ventricular function with trastuzumab?

Serial assessment of left ventricular function with 2- dimensional echocardiography or radionuclide ventriculography is the most practical means of monitoring cardiotoxicity. Patients who develop cardiotoxicity while receiving trastuzumab therapy generally improve once use of the agent is discontinued.

What is the rate of heart failure with trastuzumab?

Trastuzumab was stopped temporarily or permanently as indicated on the basis of adequate or insufficient recovery, respectively. In these four large trials, the incidence of significant LVEF decline ranged from 7.1% to 18.6%, whereas the rate of NYHA class III or IV heart failure ranged from 0.4% to 4.1%.

What kind of cancer can trastuzumab be used for?

Trastuzumab, an epidermal growth factor receptor 2 (HER2) targeting humanized monoclonal antibody, has been approved for the treatment HER2-positive breast cancer and HER2-positve metastatic gastric cancer.