Implications of excess weight in the cardiotoxicity of anthracyclines and trastuzumab in breast cancer

International audienceAnthracyclines are anticancer agents with a broad spectrum of activity in oncological practice. However, the use of anthracyclines is limited by the cardiotoxicity they may induce [1]. Following the administration of anthracyclines in the setting of adjuvant therapy for breast cancer, trastuzumab (Herceptin), a humanized monoclonal antibody against the human epidermal growth factor receptor 2 (HER 2) protein, is effective in patients that overexpress this receptor [1]. The addition of trastuzumab therapy to sequential anthracycline and taxane adjuvant treatment reduced the risk of breast cancer recurrence by nearly one-half, and the risk of death by one-third [2]. However, while preclinical studies did not reveal cardiotoxicity, later clinical studies showed that treatment with trastuzumab led to an unexpected incidence of cardiac side-effects [3]. The most frequent effect was reduced systolic ventricular function, asymptomatic or associated with heart failure