Conclusion
Although the overall incidence of cardiac toxicities is very low, dual
HER-2 targeted therapy in breast cancer significantly increase the risk
of developing LVEF and CHF when compared to anti-HER-2 alone. Sub-group
analysis that addition of dual HER-2 blockade to adjuvant treatment in
breast cancer increased the risk of developing cardiac toxicities but
not for neoadjuvant or metastatic settings. Concomitant treatment with
dual HER2 blockade would increase the risk of developing cardiac
toxicities. Physicians should be aware of this risk and provide close
monitoring during the administration of dual HER-2 targeted therapy.