LVEF monitoring in regimens including Perjeta and trastuzumab should include assessment at baseline and at what interval during neoadjuvant therapy?

• A. Prior to initiation and every six weeks during treatment
• B. Baseline only
• C. Every six months
• D. Only if symptoms arise

Answer: (A)

Regular assessment of heart function is essential when using HER2-targeted therapies like pertuzumab and trastuzumab because they can affect the heart’s pumping ability. Start with a baseline LVEF to know where you’re starting, then monitor periodically to detect declines early and prevent progression to symptoms or heart failure.

In neoadjuvant regimens that include these two agents, LVEF is typically checked before starting treatment and again every six weeks during treatment. This cadence aligns with the treatment schedule and provides timely data after about two cycles, allowing clinicians to pause or adjust therapy if a meaningful decrease in LVEF occurs.

Baseline assessment alone would miss subsequent declines; monitoring only if symptoms arise would miss asymptomatic impairment; and checking every six months would be too infrequent for a regimen with potential cardiotoxic effects.