ArticleThe oncologist2023
Three-Year Outcomes Following Permissive Cardiotoxicity in Patients on Trastuzumab.
Article in The oncologist, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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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
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Safety of Permissive Cardiotoxicity of Trastuzumab in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.Cardiovascular toxicology · 2025Pooled it
- Mechanistic attenuation by L-carnitine of trastuzumab-induced downregulation of adenosine monophosphate -activated protein kinase signal in cardiac H9c2 cells.BMC pharmacology & toxicology · 2026Article
- Association Between Body Mass Index and Cardiac Dysfunction During Human Epidermal Growth Factor Receptor 2 Inhibitor Therapy for Breast Cancer.Circulation reports · 2026Article
- Cardioprotective effects of platycodon grandiflorum granules in HER2-positive early breast cancer patients receiving trastuzumab plus pertuzumab: study protocol for a double blind randomized controlled trial.BMC complementary medicine and therapies · 2026Article
- The state of cardio-oncology in Oman: awareness, practices, and training needs among healthcare providers: a survey-based study.Cardio-oncology (London, England) · 2026Article
- Permissive Cardiotoxicity in HER2-Positive Metastatic Breast Cancer With Moderate Left Ventricular Dysfunction.JACC. Case reports · 2026Article
- Cancer Therapy-Related Cardiac Dysfunction, Risk Stratification, and Outcomes in ICOP Registry: First Data from the Arabian Middle East Region.Global heart · 2026Article
- Mitigating Trastuzumab-Doxorubicin Cardiotoxicity With Multiscale Quantitative Systems Toxicology and PBPK-Toxicodynamic Predictive Modeling Framework.CPT: pharmacometrics & systems pharmacology · 2025Article
- Permissive Cardiotoxicity and Determination of Anthracycline Risk With Previous Anthracycline Exposure.JACC. Case reports · 2025Article
- Optimal follow-up duration of cardiac function tests in patients treated with trastuzumab: an analysis using the Japanese Adverse Drug Event Report (JADER) database.International journal of clinical oncology · 2025Article
- Cardiovascular Considerations During Cancer Therapy: Gaps in Evidence andJACC. CardioOncology · 2024Review
- Predictors of trastuzumab-induced cardiotoxicity among racially and ethnically diverse patients with HER2-positive breast cancer.Cardio-oncology (London, England) · 2024Article
- Cardio-Oncology Care Delivery for All Patients With Cancer Within Academic and Community Settings.JACC. CardioOncology · 2024Article
- Precision Cardio-oncology: Update on Omics-Based Diagnostic Methods.Current treatment options in oncology · 2024Review
- Anthracyclines induce cardiotoxicity through a shared gene expression response signature.PLoS genetics · 2024Article
- Review of the clinical status of cardiotoxicity of HER-2 positive breast cancer targeted therapeutic drugs.Frontiers in oncology · 2024Review
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCardiotoxicity, manifest by reduced left ventricular ejection fraction (LVEF), is the most common reason for the premature discontinuation of trastuzumab. While permissive cardiotoxicity (where mild cardiotoxicity is accepted to enable ongoing trastuzumab) has been shown feasible, the longer-term outcomes are unknown. We aimed to study the intermediate-term clinical outcomes of patients who underwent permissive cardiotoxicity. MATERIALS AND
methodsWe performed a retrospective cohort study of patients referred to the cardio-oncology service at McMaster University from 2016 to 2021 for LV dysfunction following trastuzumab administration.
resultsFifty-one patients underwent permissive cardiotoxicity. The median (25th-75th percentile) follow-up time from cardiotoxicity onset was 3 years (1.3-4 years). Forty-seven (92%) patients completed trastuzumab; 3 (6%) developed severe LV dysfunction or clinical heart failure (HF) while on trastuzumab and prematurely discontinued therapy. One discontinued trastuzumab by patient choice. At final follow-up after therapy completion, 7 (14%) patients still had mild cardiotoxicity, including 2 who had clinical heart failure and stopped trastuzumab early. Among those with recovered LV function, 50% had normalized LVEF or GLS by 6 and 3 months, respectively, after initial cardiotoxicity. There was no difference in characteristics between those who did or did not recover their LV function.
conclusionsAmong patients exposed to permissive trastuzumab cardiotoxicity for HER2-positive breast cancer, 6% were unable to complete planned trastuzumab due to severe LV dysfunction or clinical HF. Although most patients recover their LV function after trastuzumab discontinuation or completion, 14% still have persistent cardiotoxicity by 3-year follow-up.
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