Human-Epidermal-growth-factor2 (HER2) receptor overexpression, observed in 20-30% of breast cancer cases, is a predictive factor for response to targeted therapies conditioned by cardiotoxicity, due to HER2 receptor blockade. The 69-year-old patient, diagnosed with breast cancer since 1995, began HER2 double block therapy in 2014 and after heart failure with a 43% left ventricular ejection fraction (LVEF) interrupts her. Subsequently, she begins other chemotherapy treatments that are ineffective having the patient developed hepatic secondaryisms. From February 2019 to today, treatment with the drug trastuzumab emtansine begins, which after 14 cycles must stop for IV degree cardiac toxicity, despite a good response to the drug. In February 2020, in order to guarantee the patient the possibility of continuing to be treated, she is enrolled in a clinical trial MEN1611 (B-Precise-01), aimed at evaluating, in HER2 positive patients, with mutation borne by PIK3CA (alpha isoform of the phosphatidylinositol-3-kinase enzyme), the efficacy and safety of the PI3K inhibitor drug (phosphatidylinositol-3-kinase). The great progress in the knowledge of breast cancer biology has led to the development of new classes of anti-HER2 drugs which, from what is shown by clinical studies, reduce the possibility of occurrence of cardiac toxicity, such as, for example, trastuzumab deruxtecan and ertumaxomab. Literature data show how the new anti-HER2 therapeutic frontiers overcome this criticality. The present case conducted on the individual patient with HER2 positive metastatic breast cancer provides useful information on the need to conduct drug toxicity analyzes to ensure not only the clinical benefit of the disease but also the quality of life.
Cardiotoxicity of anti-HER2 drugs in the treatment of metastatic breast cancer: Case report
Zito C.;Monopoli C.;Vero A.;Naturale M. D.;Staropoli N.;
2020-01-01
Abstract
Human-Epidermal-growth-factor2 (HER2) receptor overexpression, observed in 20-30% of breast cancer cases, is a predictive factor for response to targeted therapies conditioned by cardiotoxicity, due to HER2 receptor blockade. The 69-year-old patient, diagnosed with breast cancer since 1995, began HER2 double block therapy in 2014 and after heart failure with a 43% left ventricular ejection fraction (LVEF) interrupts her. Subsequently, she begins other chemotherapy treatments that are ineffective having the patient developed hepatic secondaryisms. From February 2019 to today, treatment with the drug trastuzumab emtansine begins, which after 14 cycles must stop for IV degree cardiac toxicity, despite a good response to the drug. In February 2020, in order to guarantee the patient the possibility of continuing to be treated, she is enrolled in a clinical trial MEN1611 (B-Precise-01), aimed at evaluating, in HER2 positive patients, with mutation borne by PIK3CA (alpha isoform of the phosphatidylinositol-3-kinase enzyme), the efficacy and safety of the PI3K inhibitor drug (phosphatidylinositol-3-kinase). The great progress in the knowledge of breast cancer biology has led to the development of new classes of anti-HER2 drugs which, from what is shown by clinical studies, reduce the possibility of occurrence of cardiac toxicity, such as, for example, trastuzumab deruxtecan and ertumaxomab. Literature data show how the new anti-HER2 therapeutic frontiers overcome this criticality. The present case conducted on the individual patient with HER2 positive metastatic breast cancer provides useful information on the need to conduct drug toxicity analyzes to ensure not only the clinical benefit of the disease but also the quality of life.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
