Breast Cancer Research and Treatment

, Volume 133, Issue 2, pp 511–521 | Cite as

Comparison of preclinical cardiotoxic effects of different ErbB2 inhibitors

  • Carmine Fedele
  • Gennaro Riccio
  • Carmela Coppola
  • Antonio Barbieri
  • Maria Gaia Monti
  • Claudio Arra
  • Carlo G. Tocchetti
  • Giuseppe D’Alessio
  • Nicola Maurea
  • Claudia De Lorenzo
Preclinical study


Two novel human antitumor immunoconjugates, made up of a human anti-ErbB2 scFv, Erbicin, fused with either a human RNase or the Fc region of a human IgG1, are selectively cytotoxic for ErbB2-positive cancer cells in vitro and in vivo. The Erbicin-derived immunoagents (EDIA) target an epitope different from that of trastuzumab, the only humanized antibody currently prescribed for treatment of ErbB2-positive breast cancer (BC). As Trastuzumab has shown cardiotoxic effects, in this study, we evaluated if any side effects were exerted also by EDIA, used as single agents or in combination with anthracyclines. Furthermore, we compared the in vitro and in vivo cardiotoxic effects of EDIA with those of the other available anti-ErbB2 drugs: Trastuzumab, 2C4 (Pertuzumab), and Lapatinib. In this article, we show that EDIA, in contrast with Trastuzumab, 2C4, and Lapatinib, have no toxic effects on human fetal cardiomyocytes in vitro, and do not induce additive toxicity when combined with doxorubicin. Furthermore, EDIA do not impair cardiac function in vivo in mice, as evaluated by Color Doppler echocardiography, whereas Trastuzumab significantly reduces radial strain (RS) at day 2 and fractional shortening (FS) at day 7 of treatment in a fashion similar to doxorubicin. Also 2C4 and Lapatinib significantly reduce RS after only 2 days of treatment, even though they showed cardiotoxic effects less pronounced than those of Trastuzumab. These results strongly indicate that RS could become a reliable marker to detect early cardiac dysfunction and that EDIA could fulfill the therapeutic need of patients ineligible to Trastuzumab treatment because of cardiac dysfunction.


ErbB2/HER2 Immunotherapy Cardiotoxicity Breast cancer Herceptin/Trastuzumab 



This study was financially supported by AIRC (Associazione Italiana per la Ricerca sul Cancro), Italy; MIUR (Ministero dell’Università e della Ricerca), Italy. The authors wish to thank Dr Philip Cunnah (Biotecnol, S.A., Portugal) for providing the anti-ErbB2 compact antibody Erb-hcAb produced by PER.C6® cells, Dr Eliana Malara for producing 2C4 antibody from the hybridoma cells, and Dr Elisa Di Pietro for her skilled assistance.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • Carmine Fedele
    • 1
  • Gennaro Riccio
    • 1
  • Carmela Coppola
    • 3
  • Antonio Barbieri
    • 4
  • Maria Gaia Monti
    • 2
  • Claudio Arra
    • 4
  • Carlo G. Tocchetti
    • 3
  • Giuseppe D’Alessio
    • 1
  • Nicola Maurea
    • 3
  • Claudia De Lorenzo
    • 1
  1. 1.Department of Structural and Functional BiologyFederico II UniversityNaplesItaly
  2. 2.Department of Clinical Medicine, Cardiovascular and Immunological SciencesFederico II UniversityNaplesItaly
  3. 3.Division of CardiologyNational Cancer Institute, G. Pascale FoundationNaplesItaly
  4. 4.Department of Animal Experimental ResearchNational Cancer Institute, G. Pascale FoundationNaplesItaly

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