Cardiac surveillance for anti HER2 chemotherapy

Surveillance of left ventricular function, part of current US Food and Drug Administration recommendations for antihuman epidermal growth factor receptor 2 (anti-HER2) chemotherapy, is based on historical data involving patients who received concomitant anthracycline therapy, a key enhancer of cardiac risk. More recent anti-HER2 treatment data suggest that cardiotoxicity detected by screening is rare and usually benign for patients who do not have cardiovascular risk factors and are not taking an anthracycline. Because of the burden of repetitive echocardiography required for surveillance and the risk of false-positive results, potentially leading to discontinuing lifesaving treatment, we advocate for a more focused cardiac surveillance strategy.

Automated summary

Surveillance of left ventricular function for anti-HER2 chemotherapy, based on historical data involving anthracycline therapy, may not be necessary for patients without cardiovascular risk factors and not taking anthracyclines, as recent data suggests cardiotoxicity detected by screening is rare and usually benign. A more focused cardiac surveillance strategy is advocated to avoid the burden of repetitive echocardiography and the risk of false-positive results leading to discontinuation of lifesaving treatment.