Trastuzumab (Herceptin) causes cardiac toxicity (cardiomyopathy) that is different from anthracycline cardiotoxicity because:

• A Trastuzumab directly causes mitochondrial oxidative damage to cardiomyocytes like anthracyclines
• B Trastuzumab cardiotoxicity is irreversible and dose-dependent due to HER2 receptor destruction
• C Trastuzumab cardiotoxicity is reversible, not cumulative dose-dependent, and does not cause ultrastructural myocardial damage ✓
• D Both trastuzumab and anthracyclines produce identical ultrastructural vacuolisation on cardiac biopsy

Explanation

Trastuzumab-associated cardiac dysfunction (TACD) is typically reversible and not cumulative dose-dependent; it occurs due to HER2 pathway suppression in cardiomyocytes (HER2 is important for cardiomyocyte survival signalling) rather than direct toxic damage. Cardiac function usually recovers after drug cessation. In contrast, anthracycline cardiotoxicity is irreversible, cumulative dose-dependent, and causes permanent ultrastructural myofibrillar loss. Their combination markedly increases cardiac risk.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.