Cardiotoxicity Associated Trastuzumab and Anthracyclines in Treating Breast Cancer Patients

Trastuzumab is a recombinant humanized monoclonal antibody thattargetsthe external domain of HER2 to enhance the effectiveness of the treatment of HER2-positive breast cancer and prevent the proliferation of cell carcinoma. Cardiac function may be impaired by trastuzumab and anthracyclines, so this study aimed to recognize the cardiac function early changes. The research has been carried out in medical center. The patients who visit the Imam Hussein Teaching Hospital (Kerbala, Iraq) Oncology Clinic, the sample included was randomly chosen. Evaluation of the cardiovascular system (history, blood pressure, physical examination and risk factors for cardiovascular disease), echocardiography and electrocardiography were conducted at baseline and repeated before the completion of treatment. The total patients that we have seen in the outpatient clinic were 86 in Al-Hussein Teaching Hospital, between 1st September 2019 and 31 of March 2020; 69 women enrolled in this study. Twelve of the total 69 cases are found to be HER-2 positive and eligible for trastuzumab (Herceptin (R)) adjuvant chemotherapy. Thirty-one cases out of the 69 completed 3 months follow up,18 (26.1%) of them have cardiac complication defined as decrease (left ventricular ejection fraction) LVEF. Measurable changes in left ventricular systolic function, in patients with breast cancer treated by trastuzumab, however,most of these are clinically symptomless and not affected in lifestyle, so it is necessary to have follow-up every 3 months.