在乳腺癌治疗中，辅助治疗抗体曲妥珠单抗的使用虽然能成功降低癌症患者的不良后果，但却会导致一系列心脏毒性副作用。最常见的心脏影响是左室射血分数（LVEF）的降低，这是心衰的先兆，通常需要停止化疗以避免进一步危及患者。因此，了解曲妥珠单抗的心脏特异性相互作用对于制定新的方法不仅避免永久性心脏损伤，而且延长治疗时间以增强乳腺癌患者的疗效至关重要。随着越来越多的证据表明运动可以保护免受LVEF降低和心衰的影响，因此在心脏肿瘤学领域，越来越多地使用运动作为治疗方法。本综述探讨了曲妥珠单抗介导的心脏毒性机制，以及运动对心脏的生理影响，以评估运动干预是否适合对曲妥珠单抗治疗的乳腺癌患者进行干预治疗。此外，我们还将与多柔比星引起的心脏毒性干预的现有证据进行比较。尽管临床前证据似乎支持曲妥珠单抗心脏毒性的运动干预方法，但目前的临床证据过于有限，无法自信地将其推荐为治疗方法，这主要是由于依从性问题引起的。因此，未来的研究应该考虑如何调整运动的种类和持续时间以提高治疗效果，以更个性化的方式制定干预方案。© 2023. The Author(s).

The use of the adjuvant therapeutic antibody trastuzumab in breast cancer is associated with a range of cardiotoxic side effects despite successfully reducing the severity of outcomes cancer patients,. The most common cardiac effect, a reduction in left ventricular ejection fraction (LVEF), is a known precursor to heart failure and often requires interruption of chemotherapy to avoid endangering patients further. An understanding of trastuzumab's cardiac-specific interactions is therefore critical in devising new methods to not only avoid permanent cardiac damage, but also prolong treatment time, and therefore effectiveness, for breast cancer patients. Increasingly, the use of exercise as a treatment has been indicated across the field of cardio-oncology due to encouraging evidence that it can protect against LVEF reductions and heart failure. This review explores the mechanisms of trastuzumab-mediated cardiotoxicity, as well as the physiological effects of exercise on the heart, in order to assess the suitability of exercise intervention for breast cancer patients on trastuzumab antibody-therapy. We furthermore draw comparison to existing evidence for exercise intervention as a cardioprotective treatment in doxorubicin-induced cardiotoxicity. Although preclinical evidence seems to support exercise-based approaches also in trastuzumab-cardiotoxicity, current clinical evidence is too limited to confidently recommend it as a treatment, largely owing to issues of adherence. Future studies should therefore examine how the variety and duration of exercise can be adjusted to improve treatment effectiveness at a more personalised level.© 2023. The Author(s).