Should I stop Herceptin if my LVEF dropped to 48?

Question

Hello doctor,

I am a 51-year-old woman recently diagnosed with HER2-positive breast cancer with lymph node involvement. I have completed six cycles of TCHP (Docetaxel, Carboplatin, Trastuzumab, and Pertuzumab).

My recent scan shows a good response, but my heart function dropped slightly on echocardiogram (LVEF 48 percent). Should we pause Herceptin temporarily to protect the heart?

Thanks.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

I am happy that you have reached the Herceptin stage, which means you have completed the six cycles of strong chemotherapy.

I want to reassure you that all your chemotherapy side effects will go away again, especially at the beginning, so there is no problem at all.

I am glad that, despite the difficulty, you were able to get through this stage. Currently, we are in the Herceptin phase, which, of course, we give as a preventive measure because HER2 (human epidermal growth factor receptor 2) has a risk of recurrence.

So we take Herceptin as a type of prevention so that it does not come back again. When the heart function decreases and reaches this level, we prefer to postpone Herceptin for 30 days.

After 30 days, you do another echo, just to make sure everything is fine, and then we start giving it again and continue Herceptin normally.

And I advise meeting a cardiologist to see if ACE (angiotensin-converting enzyme) inhibitors will protect your heart against Herceptin cardiotoxicity.

I hope my answer is clear to you, and I wish you continuous health, wellness, and recovery. If you need to ask anything at any time, do not hesitate to ask. I am always at your service.

I hope this information will help you.

Thanks.