Investigating the Long-term Cardiac Sequelae of Trastuzumab Therapy

The introduction of trastuzumab for the treatment of patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer has had a major impact upon cancer outcomes. However, cardiac toxicity remains a substantial concern. Conventionally, this toxicity has been considered as a transient and reversible phenomenon occurring in the immediate peri-treatment period in around 20% of patients. Current guidelines recommend monitoring heart function during treatment and at completion. Recent registry data suggest that trastuzumab-related cardiotoxicity may also manifest in the longer-term. The nature and longer-term prevalence of left ventricular dysfunction with HER2 positive breast cancer treated with trastuzumab is unclear. The aim of this project is to define the prevalence of left ventricular dysfunction late after completion of trastuzumab therapy.

Sex

Female

Minimum age

18 Years

Inclusion Criteria:

* patients with HER2 positive breast cancer who received anthracycline-containing chemotherapy followed by trastuzumab at least 5 years prior to enrolment;
* age \>18 years.

Exclusion Criteria:

* standard contraindication to CMR (ex: pacemaker, metallic implant);
* pregnancy;
* eGFR \<30 ml/min/1.73 m2) past medical history of heart failure or left ventricular systolic dysfunction.

Healthy Volunteers:

Twenty age and sex matched healthy volunteers will undergo a similar CMR protocol.

Inclusion Criteria:

* least 18 years (they will be matched to the study participants)
* no prior medical history (including cardiovascular health problems, medication or systemic illness)

Exclusion Criteria:

* standard contraindication to CMR;
* suspected pregnancy