Concurrent Administration of Trastuzumab and Anthracycline for Breast Cancer Treatment: An Unassailable Contraindication?

Abstract

Anthracyclines have a severe adverse effect in cardiac function. Same here, trastuzumab has cardiotoxicity even in single use and also should lead to exacerbation of anthracycline-induced cardiotoxicity. Concurrent administration of anthracycline and trastuzumab is dangerous, but sequential administration is also dangerous. We should carefully design trastuzumab-containing regimens based on anthracycline dosing, regardless of whether it is concurrent or sequential. Contraindication of concurrent use of anthracyclines and trastuzumab has distracted us from its potential efficacy as well as from the inherent danger of anthracyclines together with trastuzumab. Avoidance of concurrent dosing is insufficient. As anthracyclines and trastuzumab are essential agents for HER2-positive breast cancer, and so, we must continue to address this issue from both safety and efficacy aspects.