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)

Noam Ponde, Ian Bradbury, Matteo Lambertini, Michael Ewer, Christine Campbell, Helene Ameels, Dimitrios Zardavas, Serena Di Cosimo, José Baselga, Jens Huober, Miguel Izquierdo, Debora Fumagalli, Ivana Bozovic-Spasojevic, Marion Maetens, Nadia Harbeck, Lajos Pusztai, Michael Berghorn, Young Hyuck Im, Manuel Ruiz Borrego, Dar Ren ChenRichard Rodeheffer, Martine Piccart, Thomas Suter, Evandro De Azambuja

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

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 anthra-cycline-naïve patients receiving trastuzumab and/or lapatinib.

Original languageEnglish (US)
Pages (from-to)631-638
Number of pages8
JournalBreast Cancer Research and Treatment
Volume168
Issue number3
DOIs
StatePublished - Dec 27 2018

Keywords

  • Brain natriuretic peptide
  • Cardiotoxicity
  • HER2 positive breast cancer
  • Lapatinib
  • Troponin T

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Ponde, N., Bradbury, I., Lambertini, M., Ewer, M., Campbell, C., Ameels, H., Zardavas, D., Di Cosimo, S., Baselga, J., Huober, J., Izquierdo, M., Fumagalli, D., Bozovic-Spasojevic, I., Maetens, M., Harbeck, N., Pusztai, L., Berghorn, M., Im, Y. H., Borrego, M. R., ... De Azambuja, E. (2018). 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 Research and Treatment, 168(3), 631-638. https://doi.org/10.1007/s10549-017-4628-3