Management of trastuzumab cardiotoxicity (breast and gastric cancer)
Alessandro Inno
(Si ringrazia l’oncologo Alessandro Inno per aver accettato di mettere a disposizione dei colleghi questa presentazione di sua proprietà).
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CONTENUTI DELLA PRESENTAZIONE
(presentazione con contenuti in inglese)
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HER Receptors Family and Mechanisms of Action of Trastuzumab
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Trastuzumab in Breast and Gastric Cancer
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Trastuzumab Cardiotoxicity in Breast and Gastric Cancer
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Pathogenesis of Trastuzumab Cardiotoxicity
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Timing of Trastuzumab Cardiotoxicity: Data from the HERA trial
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Cardiac Safety of Long-Term Trastuzumab – The ROP study
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Reversibility of Trastuzumab Cardiotoxicity: Data from the HERA trial
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Cardiotoxicity is the first cause of Trastuzumab discontinuation in the Breast Cancer adjuvant setting
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Management of Trastuzumab Cardiotoxicity: Clinical Considerations
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Primary prevention (Risk Factors, Cardioprotective Agents, De-escalating Treatment)
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Risk Factors Related To Patient: CV Risk Factors
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Risk Factors Related To Treatment: Previous Anthracyclines
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ACEi / BBs / ARBs – MRI Studies: Results
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Candesartan to prevent Trastuzumab-related Cardiotoxicity
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Lisinopril or Carvedilol to prevent Trastuzumab-related Cardiotoxicity
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Duration of Adjuvant Trastuzumab: 1-year vs less (9/26 wks)
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Secondary prevention (Early diagnosis and Treatment)
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Is There a Role for Biomarkers?
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ECHO as a Monitoring Tool
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Is There a Role for GLS?
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Algorithm for the Management of Trastuzumab Cardiotoxicity: Italian Multi-Society Recommandations
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Treatment of Trastuzumab Cardiotoxicity
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Tertiary prevention (Trastuzumab in pts with Cardiac Events or Reduced LVEF at Baseline)
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HER2-targeted Therapies in pts with Compromised Cardiac Function – The SAFE-HEaRt study
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Continuing Trastuzumab Despite Mild Cardiotoxicity – The SCHOLAR study
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Take-Home Messages
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