Targeted therapies (biological therapies)

Targeted therapies are also known as biological therapies. They are used to treat several different cancers. Some targeted therapy drugs can affect the heart.

Trastuzumab (Herceptin®) is given to women to reduce the risk of HER2 positive breast cancer coming back. It is also used to treat advanced HER2 positive breast cancer. Trastuzumab can weaken the heart muscle in some women. The risk of heart problems is greater if a woman is overweight. There may not be any symptoms but some people may get breathless, have chest discomfort and fatigue.

You will have tests to check your heart function before treatment with trastuzumab. You will also have regular checks during treatment. If your heart function changes, your treatment might be temporarily stopped.

There are other targeted therapies that are used to treat different types of cancer. Some of them can affect the heart or cause high blood pressure.

Your doctor will let you know if the treatment you are having might cause problems with your heart.

Targeted therapies (also known as biological therapies)

Targeted therapy drugs are used to treat a number of different cancers. Some of these drugs can affect the heart.

Trastuzumab (Herceptin®)

Trastuzumab is given to reduce the risk of breast cancer coming back in women who have HER2 positive breast cancer. It’s also used to treat advanced HER2 positive breast cancer.

In some women, trastuzumab weakens the heart muscle, which means the heart can’t work as well as it did before (heart failure). It may not cause any symptoms, but in more severe cases, it can lead to breathlessness, chest discomfort and fatigue. The risk of trastuzumab causing heart problems increases if a woman is overweight.

You will have tests, such as an ultrasound of the heart (echocardiogram) to check your heart function before starting treatment with trastuzumab, and at regular intervals during treatment. If your heart function changes, your treatment may be stopped temporarily and you may be referred to a cardiologist. Your treatment may be restarted once your heart function has improved or returned to normal.

Women with existing heart problems are not usually given trastuzumab, as they are more likely to develop serious heart problems with treatment.


Other targeted therapies

Other targeted therapies can also affect the heart. They include:

  • Pertuzumab (Perjeta®) and lapatinib (Tykerb®) – These drugs are sometimes used to treat HER2 positive breast cancer. Pertuzumab may be given either with – or instead of – trastuzumab.
  • Bevacizumab (Avastin®) – This drug may be used to treat several different types of cancer, including bowel cancer, breast cancer and ovarian cancer.
  • Sunitinib (Sutent®), sorafenib (Nexavar®) and pazopanib (Votrient®) – These drugs are given to treat kidney cancer and a rare soft tissue cancer that usually starts in the stomach or small bowel, known as a gastrointestinal stromal tumour (GIST).
  • Imatinib (Glivec®) and dasatinib (Sprycel®) – These drugs are given to treat different types of leukaemia and GIST.
  • Dabrafenib (Tafinlar®) and vemurafenib (Zelboraf®) – These drugs are used to treat a specific form of malignant melanoma.

These drugs work by stopping cancer cells from growing. Some stop the cancer cells developing a new blood supply.

They can cause high blood pressure in some people. Your blood pressure will be checked regularly during your treatment. Let your doctor know if you have headaches, nosebleeds or feel dizzy. A number of different drugs can be used to treat high blood pressure. See our list of heart drugs.

Sunitinib, sorafenib and pazopanib can occasionally cause problems with the blood supply to the heart. If you have chest pain or breathlessness during your treatment, contact your doctor immediately.

Some other targeted therapies can also affect the heart. Your doctor can let you know if the type of treatment you are having is likely to cause problems.


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We worked with British Heart Foundation to write our content on heart health.

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Back to Cancer treatment and your heart

Chemotherapy

A few chemotherapy drugs affect the heart. Your hospital team will talk to you about any risks of the drugs you’re having.

Radiotherapy

Radiotherapy only affects the heart if it’s in the area treated. Improvements in radiotherapy treatment have reduced the risk of problems.

Hormonal therapies

Treatment with hormonal therapies can sometimes increase the risk of heart problems.

Surgery for cancer

You’ll usually have tests to check your heart before you have an operation to treat a cancer.

Cancer research trials

If you take part in a clinical trial, you will have regular checks for any side effects.

Managing heart problems

If you have heart problems during cancer treatment, your doctors will help you decide on the best way to manage them.