How would you modify therapy for a metastatic HER2+ breast CA who develops persistent cardiomyopathy after dual HER2 blockade with trastuzumab + pertuzumab?   

The clinical data suggests that dual blockade is not associated with significantly increased cardiomyopathy over trastuzumab based therapy alone. In significant cases holding anti-HER2 therapy for 4-8 weeks can allow the dysfunction to reverse while medical therapy for CHF is optimized. After recove...

Lack of data...so as outlined by dr Soliman - personalized approach. Try what you can.