What are your treatment options for HER2 over-expressing metastatic breast cancer in a patient whose LVEF decreased to <50% from normal baseline on HER2-directed therapy and EF fails to improve after holding therapy for 2 months?  

The decision for stopping HER2 therapy for cardiomyopathy should be weighed against the risk of their metastatic disease progressing on suboptimal therapy. With closer monitoring and help from a cardiologist to optimize medical management, I have been able to continue effective anti-HER2 therapy in ...