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Case Reports
. 2013 May;8(2):146-8.
doi: 10.1159/000346844.

Trastuzumab-induced hepatotoxicity: a case report

Darko Vucicevic  1 , Elizabeth J Carey  2 , Nina J Karlin  3
Affiliations
Case Reports

Trastuzumab-induced hepatotoxicity: a case report

Darko Vucicevic et al. Breast Care (Basel). 2013 May.

Abstract
in English, German

Background: Trastuzumab is a humanized monoclonal antibody approved for the treatment of breast cancer with HER2 amplification and/or overexpression. There are only 2 prior cases of trastuzumab-related hepatotoxicity reported in the literature.

Case report: We report the case of a 60-year-old woman who was treated with trastuzumab for stage I invasive ductal carcinoma of the right breast. She successfully completed 6 months of therapy when an increase in liver transaminases was noted on routine examination. A full work-up for causes of acute and chronic liver disease was negative. After review of the patient's medication list, trastuzumab was thought to be the most likely culprit for the liver injury, based on timing of administration and rise in liver enzymes.

Hintergrund: Trastuzumab ist ein humanisierter monoklonaler Antikörper, der für die Behandlung von Brustkrebs mit HER2-Amplifikation und/oder -Überexpression zugelassen ist. Nur 2 frühere Fallberichte über eine Trastuzumab-assoziierte Hepatotoxizität sind in der Literatur zu finden.

Fallbericht: Wir berichten über den Fall einer 60-jährigen Frau, die aufgrund eines invasiven duktalen Karzinoms im Stadium I in der rechten Brust mit Trastuzumab behandelt wurde. Nach 6 Monaten erfolgreicher Therapie wurden bei ihr bei einer Routineuntersuchung erhöhte Lebertransaminasenspiegel festgestellt. Eine detaillierte Testauswertung hinsichtlich möglicher Auslöser einer akuten oder chronischen Lebererkrankung ergab ein negatives Resultat. Nach eingehender Prüfung der Medikationsliste der Patientin wurde aufgrund der zeitlichen Relation zwischen der Verabreichung und der Erhöhung der Leberenzymwerte Trastuzumab als die wahrscheinlichste Ursache für die Leberschädigung angenommen.

Keywords: Breast cancer; Hepatotoxicity; Liver toxicity; Trastuzumab.

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Figures

Fig. 1
Fig. 1
Timeline of the liver function test abnormality. The last dose of trastuzumab was received on day 0. The x-axis represents time in days. Total bilirubin and INR remained within normal limits throughout the follow-up period. AST = Aspartate transaminase, ALT = alanine transaminases, AP = alkaline phosphatase.
See this image and copyright information in PMC

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