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Cardiotoxicity in HER2-positive breast cancer patients

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Abstract

Due to the recent advances in diagnosis and management of patients with HER2-positive breast cancer, especially through novel HER2-targeted agents, cardiotoxicity becomes an emerging problem. Although chemotherapy significantly increases survival, the risk of cardiovascular disease development is high and still underestimated and could imply treatment discontinuation. Frequently, due to lack of rigorous diagnosis strategies, cardiotoxicity assessment is delayed, and, moreover, the efficacy of current therapy options in restoring heart function is questionable. For a comprehensive risk assessment, it is vital to characterize the clinical spectrum of HER2-targeted agents and anthracyclines, as well as their pathogenic pathways involved in cardiotoxicity. Advanced cardiovascular multimodal imaging and circulating biomarkers plays primary roles in early assessing cardiotoxicity and also in guiding specific preventive measures. Even though the knowledge in this field is rapidly expanding, there are still questions that arise regarding the optimal approach in terms of timing and methods. The aim of the current review aims to providean overview of currently available data.

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Acknowledgments

The authors wish to acknowledge the contribution of Andrei Tomeci for graphical support.

Funding

The work was supported by Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, contract no.2461/29/17.01.2020 and by grant PN-III-P2-2.1-PED-2019–0844.

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Authors and Affiliations

  1. 2nd Department of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Diana Gonciar, Alexandru Zlibut & Lucia Agoston-Coldea

  2. 3rd Surgery Department, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Lucian Mocan

  3. Physiology Department, Iuliu Hațieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania

    Teodora Mocan

  4. Department of Nanomedicine, Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania

    Lucian Mocan & Teodora Mocan

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  1. Diana Gonciar
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Diana Gonciar, Alexandru Zlibut, and Lucia Agoston-Coldea performed the literature search and data analysis. The article was written by Diana Gonciar, Lucian Mocan, and Alexandru Zlibut. The content of the article was assessed by Teodora Mocan and Lucia Agoston-Coldea and further edited by Diana Gonciar and Alexandru Zlibut before submission.

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Correspondence to Lucia Agoston-Coldea.

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Gonciar, D., Mocan, L., Zlibut, A. et al. Cardiotoxicity in HER2-positive breast cancer patients. Heart Fail Rev 26, 919–935 (2021). https://doi.org/10.1007/s10741-020-10072-8

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