Evidence map›Paper›PMID 40627298›Full record

SynthesisCardiovascular toxicology2025

Safety of Permissive Cardiotoxicity of Trastuzumab in Patients with Breast Cancer: A Systematic Review and Meta-Analysis.

Amira Mohamed Taha, Ramez M Odat, Wesam Abd El-Tawab Moawad, Sara Adel Abdelkader Saed, Basma Ehab Amer, Dang Nguyen, Dalal Salama Salem, Linh Tran, Loay Kassem

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cardiovascular toxicology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Amira Mohamed TahaFaculty of Medicine, Fayoum University, Fayoum, Egypt.
Ramez M OdatFaculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Wesam Abd El-Tawab MoawadFaculty of Pharmacy (Girls), Al-Azhar University, Cairo, Egypt.
Sara Adel Abdelkader SaedMARS Global, London, UK.
Basma Ehab AmerFaculty of Medicine, Benha University, Benha, Egypt. basma.ehab15@gmail.com.ORCID 0000-0001-7787-5508
Dang NguyenMassachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA, USA.
Dalal Salama SalemClinical oncology department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Linh TranUniversity of Health Sciences, Vietnam National University Ho Chi Minh City, Ho Chi Minh City, Vietnam.
Loay KassemClinical oncology department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cardiotoxicity is a recognized adverse effect associated with anti-HER2 therapies. The Trastuzumab-mediated cardiac dysfunction is not dose-dependent and lacks ultrastructural changes, allowing potential recovery after a few months. There is no consensus on the management of patients who develop cardiotoxicity. This meta-analysis aims to assess the safety of the permissive cardiotoxicity of Trastuzumab in patients with breast cancer. We searched PubMed, Cochrane Library, and Embase up to October 2023 for retrospective or prospective studies that investigated the safety of Trastuzumab in patients with breast cancer who continued Trastuzumab therapy after asymptomatic ejection fraction (EF) decline. We conducted a pooled meta-analysis for the subsequent cardiac events, cardiac mortality, and all-cause mortality. We assessed the quality of included studies using the Newcastle-Ottawa Scale and ROBIN-1 tool. A total of eight cohort studies (six retrospective and two prospective), comprising 222 patients, were found eligible and were included in our analysis. The pooled incidence of cardiac events, cardiac-related mortality, and all-cause mortality was 18% (95% CI 13% to 24%), 5% (95% CI 2% to 10%), and 8% (95% CI 2% to 28%), respectively. The incidence of symptomatic or severe cardiac events was lower in those who received cardioprotective medications concomitant with Trastuzumab. Most patients received either angiotensin-converting-enzyme inhibitors, beta-blockers, or a combination of both. Continuation of planned Trastuzumab therapy with concomitant use of cardioprotective medications can be a safe and effective approach for breast cancer control in patients with asymptomatic EF decline.

Indexed as

Antineoplastic Agents, ImmunologicalBreast NeoplasmsHeart DiseasesTrastuzumabVentricular Function, LeftCardiotoxicityFemaleHeart Disease Risk FactorsHumansIncidenceRisk AssessmentRisk FactorsStroke VolumeTime FactorsTreatment OutcomeAntineoplastic Agents, ImmunologicalTrastuzumabBreast cancerCardiotoxicityEFTrastuzumab

Identifiers

PMID40627298
PMCPMC12310907

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Registered trials

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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.