{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:34:08Z","timestamp":1792683248714,"version":"4.5.0"},"reference-count":56,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/CRTF\/22\/24395"],"award-info":[{"award-number":["FS\/CRTF\/22\/24395"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/CRTF\/24\/24669"],"award-info":[{"award-number":["FS\/CRTF\/24\/24669"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"NIHR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018942","name":"Biomedical Research Centers","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018942","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008721","name":"University College London Hospitals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008721","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHS Trust"},{"DOI":"10.13039\/100020098","name":"Innovative Health Initiative","doi-asserted-by":"publisher","award":["101253264"],"award-info":[{"award-number":["101253264"]}],"id":[{"id":"10.13039\/100020098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union\u2019s","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Horizon Europe research and innovation programme"},{"name":"COCIR"},{"DOI":"10.13039\/100013322","name":"EFPIA","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013322","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Europa B\u00edo"},{"name":"MedTech Europe"},{"name":"Vaccines Europe"},{"name":"ECG M\u00e9dica SL"},{"name":"Fondation Leducq Network of Excellence in Cardio-Oncology"},{"name":"Royal Brompton Cardio-Oncology Centre of Excellence"},{"name":"Big Heart Foundation"},{"name":"EU HORIZONS ICI COMPASS programme"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Heart failure therapy (HFT) is routinely continued in breast cancer survivors after recovery from anti-HER2 cancer therapy-related cardiac dysfunction (CTRCD), despite limited evidence. HER-SAFE is the first randomized trial to assess HFT withdrawal in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this open-label, multicentre, randomized controlled, non-inferiority trial, breast cancer survivors with recovered anti-HER2 CTRCD (asymptomatic, left ventricular ejection fraction [LVEF] \u226550%, normalized biomarkers) were randomized to HFT withdrawal or continuation. Antecedent CTRCD was mild (relative global longitudinal strain [GLS] decline &amp;gt;15%, LVEF \u226550%), moderate (LVEF fall &amp;gt;10% to &amp;lt;50%), or severe (LVEF &amp;lt;40%). The primary endpoint was a moderate or severe CTRCD event over 12 months analysed by intention to treat; secondary endpoints included serial cardiac function, biomarkers, and quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between July 2023 and June 2025, 90 patients were randomized (all female; median age 50 years [IQR 43\u201359]; median 17.3 months [IQR 7.7\u201333.2] since CTRCD recovery; HFT predominantly renin\u2013angiotensin system inhibitors [98%] and beta-blockers [88%])\u201446 randomized to HFT withdrawal (1 lost to follow-up) and 44 to continuation. The primary endpoint occurred in 1 of 45 with withdrawal (moderate asymptomatic CTRCD) vs 0 of 44 with continuation (between-group difference 2.2pp; 90% CI upper limit 9.4pp - below the pre-specified 10pp non-inferiority margin). No cardiovascular deaths, heart failure hospitalizations or symptomatic CTRCD occurred. Cardiac magnetic resonance imaging-derived LVEF remained stable in both arms at 12 months (between-group difference \u22120.8% [\u22122.0 to +0.4], P = .21).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among breast cancer survivors with recovered anti-HER2 CTRCD, HFT withdrawal was not associated with symptomatic events or significant between-group difference in LVEF at 12-months.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehag707","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T11:33:56Z","timestamp":1787484836000},"source":"Crossref","is-referenced-by-count":2,"title":["Safety of withdrawal of pharmacological treatment after recovery from HER2 therapy-related cardiac dysfunction: the HER-SAFE 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Hospitals , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5400-7983","authenticated-orcid":false,"given":"Robin","family":"Chung","sequence":"additional","affiliation":[{"name":"Barts Heart Centre , Barts Health NHS Trust, London ,","place":["UK"]},{"name":"Whittington Health NHS Trust Department of Cardiovascular Medicine, , London ,","place":["UK"]},{"name":"University College London Hospital NHS Trust Cardio-Oncology Service, , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Qashou","sequence":"additional","affiliation":[{"name":"Whittington Health NHS Trust Department of Cardiovascular Medicine, , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James M","family":"Wilson","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science, University College London , Gower Street, London WC1E 6BT ,","place":["UK"]},{"name":"Barts Heart Centre , Barts Health NHS Trust, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifza","family":"Hussain","sequence":"additional","affiliation":[{"name":"Barts Heart Centre , Barts Health NHS Trust, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Meredith","sequence":"additional","affiliation":[{"name":"Barts Heart Centre , Barts Health NHS Trust, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8546-5023","authenticated-orcid":false,"given":"Iain","family":"Pierce","sequence":"additional","affiliation":[{"name":"Barts Heart Centre , Barts Health NHS Trust, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Barts Heart Centre , Barts Health NHS Trust, London 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