Catching broken hearts: pre-clinical detection of doxorubicin and trastuzumab mediated cardiac dysfunction in the breast cancer setting

Can J Physiol Pharmacol. 2014 Jul;92(7):546-50. doi: 10.1139/cjpp-2013-0470. Epub 2014 Jan 31.

Abstract

Although breast cancer is one of the leading causes of death in women worldwide, there is an overall improvement in the survival of this patient population. This is likely due to a combination of early detection through screening and awareness, improved targeted biological therapy, and an overall improvement in disease management. Despite the beneficial effects of the 2 anti-cancer drugs doxorubicin (DOX) and trastuzumab (TRZ) in women with breast cancer, development of cardiotoxicity is a major concern. The occurrence of left ventricular systolic dysfunction is unacceptably high in nearly 1 in 4 women treated with DOX+TRZ in the breast cancer setting. In this review, we explore the use of non-invasive cardiac imaging for the early detection of chemotherapy-mediated cardiotoxicity in women with breast cancer, in the hope of preventing end-stage heart disease in this cancer population.

Keywords: cardiac magnetic resonance imaging; cardio-oncologie; cardio-oncology; doxorubicin; doxorubicine; imagerie cardiaque par résonance magnétique; transthoracic echocardiography; trastuzumab; échocardiographie trans-thoracique.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Cardiac Imaging Techniques
  • Cardiotoxicity / diagnosis*
  • Cardiotoxicity / etiology
  • Cardiotoxicity / prevention & control
  • Doxorubicin / adverse effects*
  • Early Diagnosis
  • Female
  • Heart / physiopathology*
  • Humans
  • Trastuzumab
  • Ventricular Dysfunction, Left / chemically induced
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / prevention & control

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Doxorubicin
  • Trastuzumab