ReviewBreast cancer research and treatment2021
Trastuzumab-induced cardiotoxicity: a review of clinical risk factors, pharmacologic prevention, and cardiotoxicity of other HER2-directed therapies.
Review in Breast cancer research and treatment, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 4 of them syntheses that pooled it.
What it found
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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.
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Who cites it
93 citing papers in PubMed, 4 syntheses or guidelines pooled it, 149 citations in OpenAlex.
- Cardiotoxicity of HER2-Targeted Drugs When Combined with Other Drugs: A Systematic and Meta-analysis of Randomized Controlled Trials.Cardiovascular toxicology · 2024Pooled it
- Interventions for prevention and treatment of trastuzumab-induced cardiotoxicity: an umbrella review of systematic reviews and meta-analyses.Frontiers in pharmacology · 2024Pooled it
- Role and efficacy of capecitabine in the anthracycline-free regimen in breast cancer patients: a systematic review and meta-analysis.Journal of cancer research and clinical oncology · 2023Pooled it
- Diagnostic Value of Three-Dimensional Speckle Tracking Imaging Strain Parameters for Detection of Cancer Chemotherapy-Related Cardiac Dysfunction: A Meta-Analysis.Arquivos brasileiros de cardiologia · 2023Pooled it
- Troponin: biology, molecular mechanisms, and multidimensional clinical applications.Molecular biomedicine · 2026Review
- Multidimensional perspectives on cancer therapy-induced cardiotoxicity: Characteristics, mechanisms, biomarkers, psychological stress effects, and treatment progress.Cancer pathogenesis and therapy · 2026Review
- HER2-directed therapy is associated with an increased rate of cardiologic emergency department visits in real-world breast cancer patients.Breast (Edinburgh, Scotland) · 2026Article
- Temporal dynamics of cardiac biomarkers in therapy‑related cardiotoxicity: a prospective cardio‑oncology cohort study.Cardio-oncology (London, England) · 2026Article
- Potency and safety of novel [British journal of cancer · 2026Article
- Cardiotoxicity Induced by Targeted Cancer Therapies: Understanding the Risks and Developing Solutions.Cardiovascular drugs and therapy · 2026Review
- Cardiotoxicity of monoclonal antibody-based therapies in breast cancer: a contemporary narrative review.Cardio-oncology (London, England) · 2026Review
- Review
- Performance of Traditional Cardiovascular Risk Scores and Objective Optimization in Cancer Survivors.Current oncology (Toronto, Ont.) · 2026Article
- Development of Cancer Therapy-Related Cardiac Dysfunction Is Associated With Disease Progression in Breast Cancer.Circulation reports · 2026Article
- 'Patients are left not knowing': Trastuzumab (Herceptin) cardiac risk information and management in HER2-positive breast cancer-a qualitative study of patient experience.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Artificial Intelligence and the Expanding Universe of Cardio-Oncology: Beyond Detection Toward Prediction and Prevention of Therapy-Related Cardiotoxicity-A Comprehensive Review.Diagnostics (Basel, Switzerland) · 2026Review
- Diabetes and cancer: therapeutic implications.Cardio-oncology (London, England) · 2026Review
- Bayesian nonparametric mixtures of categorical directed graphs for personalized causal inference.Biostatistics (Oxford, England) · 2026Article
- Signaling pathways and potential therapeutic agents in trastuzumab-induced cardiotoxicity.Apoptosis : an international journal on programmed cell death · 2026Review
- The ROOT-CTRCD study: exploring the relationship of oral health to cancer therapy-related cardiac dysfunction in HER2-positive breast cancer patients.Cardio-oncology (London, England) · 2026Article
33 more citing papers are in PubMed but not listed here.
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
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite great success as a targeted breast cancer therapy, trastuzumab use may be complicated by heart failure and loss of left ventricular contractile function. This review summarizes the risk factors, imaging, and prevention of cardiotoxicity associated with trastuzumab and other HER2-targeted therapies.
findingsCardiovascular disease risk factors, advanced age, and previous anthracycline treatment predispose to trastuzumab-induced cardiotoxicity (TIC), with anthracycline exposure being the most significant risk factor. Cardiac biomarkers such as troponins and pro-BNP and imaging assessments such as echocardiogram before and during trastuzumab therapy may help in early identification of TIC. Initiation of beta-adrenergic antagonists and angiotensin converting enzyme inhibitors may prevent TIC. Cardiotoxicity rates of other HER2-targeted treatments, such as pertuzumab, T-DM1, lapatinib, neratinib, tucatinib, trastuzumab deruxtecan, and margetuximab, appear to be significantly lower as reported in the pivotal trials which led to their approval.
conclusionsRisk assessment for TIC should include cardiac imaging assessment and should incorporate prior anthracycline use, the strongest risk factor for TIC. Screening and prediction of cardiotoxicity, referral to a cardio-oncology specialist, and initiation of effective prophylactic therapy may all improve prognosis in patients receiving HER2-directed therapy. Beta blockers and ACE inhibitors appear to mitigate risk of TIC. Anthracycline-free regimens have been proven to be efficacious in early HER2-positive breast cancer and should now be considered the standard of care for early HER2-positive breast cancer. Newer HER2-directed therapies appear to have significantly lower cardiotoxicity compared to trastuzumab, but trials are needed in patients who have experienced TIC and patients with pre-existing cardiac dysfunction.
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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.