- 著者
- Kenta Uto Michinobu Nagao Saeko Yoshizawa Noriko Kikuchi Nobuhisa Hagiwara Yoji Nagashima
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-21-0521, (Released:2021-07-09)
- 参考文献数
- 1
- 被引用文献数
- 1
- 著者
- Tsuyoshi SHIGA Takako KAMIO Kenta UTO Kotaro ARAI
- 出版者
- The Japanese Society of Clinical Pharmacology and Therapeutics
- 雑誌
- 臨床薬理 (ISSN:03881601)
- 巻号頁・発行日
- vol.52, no.4, pp.101-105, 2021-07-31 (Released:2021-08-18)
- 参考文献数
- 18
- 被引用文献数
- 1
Trastuzumab, a humanized monoclonal antibody, is used in the treatment of metastatic breast cancer overexpressing human epidermal growth factor receptor 2 (HER2). Trastuzumab-related cardiotoxicity can usually be reversed by interrupting the use of the drug. We present a 78-year-old woman with metastatic HER2-positive breast cancer whose left ventricular ejection fraction (LVEF) decreased from 56% to 37% within 3 months after starting trastuzumab treatment prior to surgery. She complained of shortness of breath on exertion. Trastuzumab was stopped immediately, and an angiotensin-converting enzyme inhibitor and a beta blocker were started. Her LVEF did not increase 6 months after the cessation of trastuzumab use. Low-dose digoxin (0.0625 mg daily) was added, and the patient's LVEF increased from 35% to 44% one month later. The next month, she was able to undergo mastectomy with axillary lymph node dissection followed by radiation and tamoxifen as adjuvant therapy. She was followed up for 3 years after surgery and experienced no recurrence of breast cancer.Trastuzumab-related cardiotoxicity can usually be reversed by interrupting the use of the drug. Patients with inadequate or nonexistent recovery of LVEF despite cardioprotective therapy cannot undergo standard cancer treatment; this restriction leads to a worsened prognosis. Low-dose digoxin in addition to cardioprotective therapy increased our patient's LVEF to over 40%, allowing her to undergo surgery.