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)

Publication

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)

Journal Paper/Review - Dec 27, 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

Citation

Ponde N, Maetens M, Harbeck N, Pusztai L, Berghorn M, Im Y, Borrego M, Chen D, Rodeheffer R, Piccart M, Suter T, Bozovic-Spasojevic I, Fumagalli D, Bradbury I, Lambertini M, Ewer M, Campbell C, Ameels H, Zardavas D, Di Cosimo S, Baselga J, Huober J, Izquierdo M, de Azambuja E. 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). Breast Cancer Res Treat 2017; 168:631-638.

Type

Journal Paper/Review (English)

Journal

Breast Cancer Res Treat 2017; 168

Publication Date

Dec 27, 2017

Issn Electronic

1573-7217

Pages

631-638

Brief description/objective

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.