Does cardiac testing before trastuzumab therapy actually make a difference?

摘要

We are left in no doubt by Lu et al that the introduction of mandatory cardiac testing for early stage disease spread over to the metastatic setting resulted in a surge in assessments by echocardiography and radionuclide ventriculography (RNV). The authors stated that the 'findings are of merit in the clinical and policy domains' noting that the study surveyed the processes of care rather than cardiac safety. It would seem to us that the two are intertwined - and inseparable. With clinical information regarding the patients, two overt and distinct possibilities arise. On one hand,if cardiac dysfunction arising in the setting of trastuzumab therapy is as uncommon as four cases out of 123, as suggested by Chan and McGregor, then reform of monitoring guidelines is urgently required to streamline resource utilisation and allocation.