Incidence and Mechanism of Cardiotoxicity in Breast Cancer Patients After Use of Trastuzumab

Abstract

Cardiotoxicity is the occurrence of heart dysfunction as electrical or muscle damage, which results in the heart becoming weaker and inefficient at pumping blood. Cardiotoxicity can be caused by several things such as chemotherapy agents, radiotherapy treatment, complications from anorexia nervosa, side effects from heavy metal intake. Cardiotoxicity also occurs in breast cancer patients given trastuzumab therapy. The aim of this review article is to determine the incidence of cardiotoxicity after the use of trastuzumab and the mechanism of the cardiotoxic effects of trastuzumab in breast cancer patients. The method used in this article is to use several searches using PubMed, ScienceDirect and Google Scholar for research discussing the cardiotoxic effects of trastuzumab in breast cancer patients from 2018 to 2023. A total of 171 articles were then evaluated based on inclusion and exclusion criteria. A total of 157 articles were excluded and 14 articles met the inclusion criteria. The mechanism of cardiotoxicity caused by trastuzumab is through HER2 inhibition and autophagy mechanisms. In conclusion, the choice of trastuzumab as a therapeutic option in breast cancer patients must be considered carefully and monitoring of cardiac function is required.

Key words: cardiotoxicity, trastuzumab, breast cancer