some anti her2 vaccines may be associated with decreased cardiac function

[Lani]

1: Am J Surg. 2009 Oct;198(4):488-94.

Asymptomatic changes in cardiac function can occur in ductal carcinoma-in-situ patients following treatment with HER-2/neu-pulsed dendritic cell vaccines.

Bahl S, Roses RE, Sharma A, Koldovsky U, Xu S, Weinstein S, Nisenbaum H, Fox K, Pasha T, Zhang P, Araujo L, Carver J, Czerniecki BJ.
Department of Surgery, Rena Rowan Breast Center, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA.
BACKGROUND: Targeting HER-2/neu with Trastuzumab has been associated with development of cardiac toxicity. METHODS: Twenty-seven patients with ductal carcinoma in situ (DCIS) of the breast completed an IRB approved clinical trial of a HER-2/neu targeted dendritic cell based vaccine. Four weekly vaccinations were administered prior to surgical resection. All subjects underwent pre- and post-vaccine cardiac monitoring by MUGA/ECHO scanning allowing for a comparison of cardiac function. RESULTS: In 3 of 27 vaccinated patients (11%) transient asymptomatic decrements in ejection fraction of greater than 15% were noted after vaccination. Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients, but cardiac toxicity was not noted until induction of cellular mediated immune responses. CONCLUSIONS: This is the first description of HER-2/neu targeted vaccination associated with an incidence of cardiac changes, and the induction of cellular immune responses combined with antibody may contribute to changes in cardiac function.
PMID: 19800453 [PubMed - in process]

[Becky]

I did comment on this before as the heart normally has Her2 receptors. When vaccinated, your own body could produce antibodies against Her2 which could also attack the heart (as well as the cancer). However, unlike Herceptin which does the same, it can be stopped while your own immune system cannot.

[DianneS]

'Notably, evidence of circulating anti-HER-2/neu antibody was found prior to vaccination in all three patients,'

What does this mean?? Does this occur with herceptin or only vaccines? How could it occur PRIOR to vaccination? I am puzzled.
Dianne