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It has been recognised that up to 25% of breast cancer overexpresses the transmembrane human epidermal growth factor receptor 2 (HER2), which, in the absence of treatment, is associated with an adverse prognosis for patients Hudis, 2007. The monoclonal antibody trastuzumab, which targets the HER2 receptor, has significantly improved both overall and disease-free survival for patients with advanced and early stage disease Slamon et al., 2001, Moja et al., 2012. However, an unexpected finding during the clinical trials of trastuzumab was the development of cardiotoxicity, mostly manifested as a decline in left ventricular ejection fraction (LVEF) and, more rarely, congestive heart failure. Despite extensive research, the mechanisms underlying trastuzumab-related cardiotoxicity remain poorly understood.

How can clinical research help our understanding of trastuzumab-related cardiotoxicity?