1 The authors noted that the toxicity of the 'relatively new' agent trastuzumab 'revealed true clinical and mechanistic differences between the cardiac effects of trastuzumab and those of anthracyclines.' As such, the manuscript proposed that anthracycline toxicity be characterized as Type I, whereas toxicity 'exemplified by trastuzumab cardiac effects' would be characterized as Type II. The terms 'Type I' and 'Type II' cardiac dysfunction were first proposed in 2005, in an editorial published in Journal of Clinical Oncology. The purpose of this article is to critically examine the major flaws in the 'Type I versus Type II' characterization scheme.įlaw 1: The Subtext to the Definition of Type II Toxicity Is Untrue Unfortunately, despite the growing evidence that this categorization is both incomplete and fundamentally incorrect, the terms continue to be used both in practice and in the literature. Click here for the Con article.įor over a decade, some cardio-oncology experts have used the terms 'Type I' and 'Type II' to describe patterns of cardiotoxicity that can arise from use of cancer therapies.

Editor's Note: This is the Pro article of a two-part Pro/Con Expert Analysis.

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