APCU25OS8 Diastolic function in patients with trastuzumab-based chemotherapy regimen: a systematic review and meta-analysis

Introduction Trastuzumab, a monoclonal antibody targeting HER2, has significantly improved outcomes in HER2-positive breast cancer patients. However, its association with cardiotoxicity, particularly myocardial toxicity, is a growing concern. While the effects of trastuzumab on systolic function are well-documented, its impact on diastolic function remains unclear. This systematic review and meta-analysis aim to evaluate diastolic echocardiographic parameters in cancer patients undergoing trastuzumab-based chemotherapy.Methods A comprehensive literature search in scientific databases were conducted up to 2024. Studies evaluating diastolic echocardiographic parameters in cancer patients undergoing trastuzumab-based chemotherapy were included.Results Findings included 17 studies involving 1,746 breast cancer patients. Pooled analysis showed significant differences in diastolic dysfunction (RR 6.89; p=0.003, I2 93%) and E velocity (MD 4.20; p=0.04, I2 19%) after trastuzumab treatment. Despite this, changes in specific diastolic parameters, such as E/A ratio, E/e′ ratio, and e′ velocity, showed inconsistent results. Notably, a significant elevation in E velocity was observed (MD 4.20, 95% CI: 0.26, 8.14; p=0.04, I2=19%).Conclusion Findings indicate the significant alterations in diastolic function among breast cancer patients undergoing trastuzumab-based chemotherapy. It underscores the importance of monitoring diastolic function in patients receiving trastuzumab, advocating for the early detection and management of cardiotoxicity. Future studies should focus on long-term follow-up and detailed assessment of diastolic function parameters, to better understand the cardiac risks associated with trastuzumab-based therapy.