TY - JOUR
T1 - Cardiac biomarkers for early detection and prediction of trastuzumab and/or lapatinib-induced cardiotoxicity in patients with HER2-positive early-stage breast cancer
T2 - A NeoALTTO sub-study (BIG 1-06)
AU - Ponde, Noam
AU - Bradbury, Ian
AU - Lambertini, Matteo
AU - Ewer, Michael
AU - Campbell, Christine
AU - Ameels, Helene
AU - Zardavas, Dimitrios
AU - Di Cosimo, Serena
AU - Baselga, José
AU - Huober, Jens
AU - Izquierdo, Miguel
AU - Fumagalli, Debora
AU - Bozovic-Spasojevic, Ivana
AU - Maetens, Marion
AU - Harbeck, Nadia
AU - Pusztai, Lajos
AU - Berghorn, Michael
AU - Im, Young Hyuck
AU - Borrego, Manuel Ruiz
AU - Chen, Dar Ren
AU - Rodeheffer, Richard
AU - Piccart, Martine
AU - Suter, Thomas
AU - De Azambuja, Evandro
N1 - Funding Information:
Funding This research has received research grant from “Les Amis de L’Institut Bordet” (Grant 2016-02).
Funding Information:
Conflicts of interest The authors of this manuscript hereby declare the following conflicts of interest regarding this manuscript: Dimi-trios Zardavas—Research Grants to his institution from Roche, Ge-nentech, Novartis, Pfizer, AstraZeneca, Tesaro, Puma Biotechnology; Jens Huober—Roche honoraria and advisory role, Novartis: honoraria and advisory role, GSK: research funding; Evandro de Azambuja—received honoraria from Roche and travel grants from Roche and Glaxo-SmithKline outside the submitted work; Martine Piccart—is a board member of Radius, is a consultant (honoraria): AstraZeneca, Lilly, MSD, Novartis, Odonate, Pfizer, Roche-Genentech, Crescendo Biologics, Periphagen, Huya, Debiopharm, PharmaMar and has received research grants to her Institute: AstraZeneca, Lilly, MSD, Novartis, Pfizer, Roche-Genentech, Synthon, Radius, Servier. All remaining authors have declared no conflicts of interest.
Funding Information:
Acknowledgements Dr. Matteo Lambertini acknowledges the support from the European Society for Medical Oncology (ESMO) for a Translational Research Fellowship at the Institut Jules Bordet in Brussels (Belgium).
Publisher Copyright:
© Springer Science+Business Media, LLC, part of Springer Nature 2017.
PY - 2018/12/27
Y1 - 2018/12/27
N2 - 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.
AB - 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.
KW - Brain natriuretic peptide
KW - Cardiotoxicity
KW - HER2 positive breast cancer
KW - Lapatinib
KW - Troponin T
UR - http://www.scopus.com/inward/record.url?scp=85039045239&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85039045239&partnerID=8YFLogxK
U2 - 10.1007/s10549-017-4628-3
DO - 10.1007/s10549-017-4628-3
M3 - Article
AN - SCOPUS:85039045239
SN - 0167-6806
VL - 168
SP - 631
EP - 638
JO - Breast Cancer Research and Treatment
JF - Breast Cancer Research and Treatment
IS - 3
ER -