Publikation
Cardiac biomarkers for early detection and prediction of trastuzumab and/or lapatinib-induced cardiotoxicity in patients with HER2-positive early-stage breast cancer: a NeoALTTO sub-study (BIG 1-06)
Wissenschaftlicher Artikel/Review - 27.12.2017
Ponde Noam, Maetens Marion, Harbeck Nadia, Pusztai Lajos, Berghorn Michael, Im Young-Hyuck, Borrego Manuel Ruiz, Chen Dar-Ren, Rodeheffer Richard, Piccart Martine, Suter Thomas, Bozovic-Spasojevic Ivana, Fumagalli Debora, Bradbury Ian, Lambertini Matteo, Ewer Michael, Campbell Christine, Ameels Helene, Zardavas Dimitrios, Di Cosimo Serena, Baselga José, Huober Jens, Izquierdo Miguel, de Azambuja Evandro
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BACKGROUND
Biomarkers of cardiac damages, such as troponin T (TnT) and the amino-terminal fragment of brain natriuretic peptide (NT-proBNP), may be useful as early predictors of cardiac dysfunction. The role of these biomarkers in patients receiving lapatinib and/or trastuzumab before anthracyclines is unknown. This study explores TnT and NT-proBNP as predictors of early cardiac toxicity in neoadjuvant breast cancer patients.
METHODS
This sub-study of the NEOALTTO trial tested if changes in the levels of TnT and NT-proBNP occurred after 2 weeks of anti-HER2 therapy (lapatinib, trastuzumab or their combination) alone and/or after 18 weeks of anti-HER2 therapy plus weekly paclitaxel.
RESULTS
173 and 172 were tested at all three timepoints for NT-proBNP and TnT, respectively. The incidence of biomarker elevation was overall low at all timepoints for all the three treatment arms. A total of 13 CEs in 11 patients occurred. Biomarker elevations in patients with CEs were very rare; only one patient with subsequent CE had a NT-proBNP elevation at baseline and at week 2.
CONCLUSION
These results suggest that TnT and proBNP may not be useful as early predictors of cardiac toxicity in anthracycline-naïve patients receiving trastuzumab and/or lapatinib.