ArticleBreast cancer research and treatment2019
Cardiac outcomes of trastuzumab therapy in patients with HER2-positive breast cancer and reduced left ventricular ejection fraction.
Article in Breast cancer research and treatment, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Safety of Permissive Cardiotoxicity of Trastuzumab in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.Cardiovascular toxicology · 2025Pooled it
- Multidimensional perspectives on cancer therapy-induced cardiotoxicity: Characteristics, mechanisms, biomarkers, psychological stress effects, and treatment progress.Cancer pathogenesis and therapy · 2026Review
- Permissive Cardiotoxicity in HER2-Positive Metastatic Breast Cancer With Moderate Left Ventricular Dysfunction.JACC. Case reports · 2026Article
- Cardiotoxicity Induced by Anticancer Therapies: A Call for Integrated Cardio-Oncology Practice.Pharmaceuticals (Basel, Switzerland) · 2025Article
- A recombinant fragment antigen-binding (Fab) of trastuzumab displays low cytotoxic profile in adult human cardiomyocytes: first evidence and the key implication of FcγRIIA receptor.Acta pharmacologica Sinica · 2025Article
- A Case of Ventricular Arrhythmia in a Patient With HER2-Positive Gastric Cancer Receiving Trastuzumab.Case reports in gastrointestinal medicine · 2025Article
- Cancer and Heart Failure: Dangerous Liaisons.Journal of cardiovascular development and disease · 2024Review
- Mechanisms of trastuzumab induced cardiotoxicity - is exercise a potential treatment?Cardio-oncology (London, England) · 2023Review
- Article
- Cardiotoxicity monitoring of pyrotinib in combination with nab-paclitaxel, doxorubicin, and cyclophosphamide in HER2-positive breast cancer: a single-armed clinical trial.Gland surgery · 2022Article
- Cardiac Toxicity From Adjuvant Targeting Treatment for Breast Cancer Post-Surgery.Frontiers in oncology · 2022Review
- Risks of trastuzumab-related cardiotoxicity in breast cancer patients in Taiwan.ESC heart failure · 2021Article
- Multiparametric Early Detection and Prediction of Cardiotoxicity Using Myocardial Strain, T1 and T2 Mapping, and Biochemical Markers: A Longitudinal Cardiac Resonance Imaging Study During 2 Years of Follow-Up.Circulation. Cardiovascular imaging · 2021Observational
- Heart failure prevention and monitoring strategies in HER2-positive breast cancer: a narrative review.Breast cancer research and treatment · 2021Review
- Cardiotoxicity of Epidermal Growth Factor Receptor 2-Targeted Drugs for Breast Cancer.Frontiers in pharmacology · 2021Review
- Prevention, Detection, and Management of Heart Failure in Patients Treated for Breast Cancer.Current heart failure reports · 2020Review
- The cancer patient and cardiology.European journal of heart failure · 2020Review
- Emerging Challenges of Radiation-Associated Cardiovascular Dysfunction (RACVD) in Modern Radiation Oncology: Clinical Practice, Bench Investigation, and Multidisciplinary Care.Frontiers in cardiovascular medicine · 2020Review
- Cardioncological Approach for Trastuzumab Therapy in Breast Cancer Patients With Cardiotoxicity: Impact on Adherence and Clinical Outcome.Frontiers in pharmacology · 2020Article
- Trastuzumab Cures Cancer and Disrupts the Practice of Cardiology.JACC. CardioOncology · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
purposeAsymptomatic decline in left ventricular ejection fraction (LVEF) or heart failure (HF) occurs in up to 25% of patients treated with trastuzumab and can result in incomplete breast cancer therapy. The cardiac safety of continuing trastuzumab in patients with asymptomatic LVEF decline is unknown. We report the cardiac outcomes of patients treated with trastuzumab after a significant asymptomatic LVEF decline.
methodsPatients with HER2-positive breast cancer and asymptomatic LVEF decline to < 50% during trastuzumab were identified from an institutional echocardiogram database. Patients who received trastuzumab with a LVEF < 50% were classified as the continued group, whereas patients who had trastuzumab held until LVEF improved to ≥ 50% or who had trastuzumab permanently discontinued were classified as the interrupted group. Cardiac events were defined as HF (New York Heart Association class III-IV) or cardiovascular death.
resultsSixty patients were included; the median age was 54 years. In 23 patients who continued trastuzumab, 14 (61%) tolerated trastuzumab without a cardiac event, 6 (26%) developed worsening LVEF (range 25-42%) leading to trastuzumab discontinuation, and three (13%) developed a cardiac event (1 HF, 2 possible/probable cardiovascular deaths). In 37 patients with interrupted trastuzumab, 15 (41%) were re-challenged with trastuzumab after LVEF improved to > 50%, 21 (57%) were not re-challenged, and one (3%) developed HF. More patients in the continued trastuzumab group had metastatic disease (39% vs. 5%, p = 0.002). The final LVEF after median follow-up of 633 days was similar between patients with trastuzumab continuation versus interruption (54% vs. 56%, p = 0.29).
conclusionContinuation of trastuzumab after an asymptomatic LVEF decline to < 50% in patients who are expected to benefit from additional anti-HER2 therapy is a promising approach that warrants further investigation.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.