The objective of this systematic review is to assess the cardiotoxicity associated with using
trastuzumab in combination with liposomal doxorubicin to conclude whether it is a viable option for
Breast Cancer Treatment. As stated before, the combination can cause lethal cardiotoxicity if
doxorubicin is used in its free form. However, with recent advancements in medical nanotechnology
which allow liposomal drug formulations and targeted drug delivery, this combination can be a potent
treatment for cancer. This review examines a few clinical trials which have tested the combination to
assess whether it is viable, by analyzing the cardiac status of the subjects.
2. Research Methodology
2.1. Search Strategies
A comprehensive literature search was conducted in October 2015 using two main search engines,
PubMed and Google Scholar. The combinations of terms used for the search included “Liposomal
Doxorubicin”, “Trastuzumab”, “HER-2 Overexpressing”, and “Breast Cancer”. Limits were applied
and only studies published in the last 10 years (2005-2015), and written in English were included.
Studies outside of the ten year range were excluded to avoid external factors such as healthcare level
and advancements in hospitalization.
2.2. Inclusion and Exclusion Criteria
Inclusion Criteria:
Clinical Trials with Human Subjects
Subjects with HER-2 positive Breast Cancer
Subjects within the age range of 18-80
Studies published in the last 10 years
Studies using Trastuzumab in combination with Liposomal Doxorubicin for treatment of
Subjects
Studies evaluating the cardiotoxicity in test subjects
Exclusion Criteria:
Studies not using the liposomal formulation of Doxorubicin
Studies that use one drug after the other, and not both concurrently
Studies not assessing treatment efficacy along with safety of the treatment regimen.
2.3. Data Extraction
The following data was extracted from the studies:
1. Baseline Left Ventricle Effusion Rates (LVEF)*