الخلاصة

ABSTRACT Trastuzumab therapy represents the standard of care for HER2 positive breast cancer patients, which is highly complicated by cardiotoxicity. The aim of the study was to elucidate the possible effects of carvedilol on echocardiographic ejection fraction, serum brain natriuretic peptide and serum C- reactive protein in trastuzumab treated females with HER2 positive breast cancer. A total of 26 females with HER2 positive breast cancer were included in this study. The patients were randomized into two groups, 13 patients in each group. Group I included patients were treated with trastuzumab therapy for 8 cycles with 21 day apart. Group II included patients were received trastuzumab therapy with carvedilol 3.125 mg, orally, twice daily dose for 8 cycles. Echocardiography was used to measure ejection fraction at zero time, 4 th and 8th cycles in both groups. Serum brain natriuretic peptide and C- reactive protein were measured at zero time, 2nd, 4th, 6th and 8th cycles in both groups. Treatment with trastuzumab therapy caused significant decrement in echocardiographic ejection fraction at only 8th cycle in comparison to baseline readings (P < 0.05). Combined trastuzumab plus carvedilol caused significant increase in echocardiographic ejection fraction compared with that of trastuzumab therapy group (P < 0.05). Regarding serum brain natriuretic peptide and C- reactive protein, trastuzumab therapy caused significant increment in both these markers in comparison to baseline readings (P < 0.05). Combined trastuzumab plus carvedilol caused significant decrement in serum brain natriuretic peptide and C- reactive protein compared with that of trastuzumab therapy group (P < 0.05). Carvedilol causes significant increment in echocardiographic ejection fraction and significant decrease in serum brain natriuretic peptide and C- reactive protein in trastuzumab treated patients. Keywords: Carvedilol, Trastuzumab, Cardiotoxicity, Ejection fraction, BNP, C-RP