unravelling way to protect heart from herceptin, chemo

[Lani]

: Exp Biol Med (Maywood). 2008 Jan;233(1):76-83. Links
Erythropoietin pretreatment protects against acute chemotherapy toxicity in isolated rat hearts.

Ramond A, Sartorius E, Mousseau M, Ribuot C, Joyeux-Faure M.
Laboratoire HP2, Faculté de Pharmacie, Domaine de la Merci, 38706 La Tronche, France. Marie. Faure@ujf-grenoble.fr.
The use of chemotherapeutic agents, such as anthracycline or trastuzumab, in oncology is limited by their cardiac toxicity. Recent experimental studies suggest that recombinant human erythropoietin (rhEPO) can be considered as a protective agent because its administration protects against cardiac ischemic injury, improving functional recovery, and reducing cell death. The aim of this study was to investigate whether pretreatment by rhEPO protects against acute cardiotoxicity induced by doxorubicin and trastuzumab, using the isolated rat heart model. Rats were treated with rhEPO (5000 IU/kg, intraperitoneally [ip]) or vehicle. One hour later, hearts were isolated and retrogradely perfused at constant flow. Following 20 mins of stabilization, hearts were perfused for 60 mins with modified-Krebs solution containing 6 mg/l doxorubicin or 10 mg/l trastuzumab. Hearts receiving doxorubicin were paced; those receiving trastuzumab were unpaced. Control hearts were perfused with modified-Krebs solution only. Doxorubicin exposure decreased left ventricular developed pressure (LVDP; approximately -40% of baseline) and increased end diastolic pressure (EDP; approximately +390% of baseline) and coronary perfusion pressure (CPP; approximately +70% of baseline). Incidence of ventricular tachycardia or fibrillation (VT/VF) was also significantly enhanced (86% vs. 0% in control group). Trastuzumab exposure increased CPP and EDP (approximately +70% of baseline for the both) without affecting LVDP. Prior rhEPO treatment significantly prevented doxorubicin-induced deleterious effects on LVDP, EDP, and VT/VF incidence. rhEPO administration also prevented trastuzumab-induced deleterious effects on CPP and EDP. This study shows that pretreatment by rhEPO protects myocardium against functional damage and electrophysiologic injury induced by acute doxorubicin or trastuzumab exposure. Further investigations are required to elucidate the precise mechanisms involved.
PMID: 18156309 [PubMed - in process]

[Kathy S in Tokyo]

Interesting. I expect that the red blood cell boosting effects would give patients under treatment a little more energy all around but wonder if the possible side effect of increased blood pressure might be problematic. I've fared well so far on Herceptin and hope to be able to stay on it as long as possible so the idea of heart protection is very attractive.