NO INCREASED TOXICITY WITH DUAL HER2 BLOCKADE 

Int J Cancer. 2013 Apr 30. doi: 10.1002/ijc.28234. [Epub ahead of print]

Cardiac toxicity in breast cancer patients treated with dual HER2 blockade.

Valachis A, Nearchou A, Polyzos NP, Lind P.

Source

Department of Oncology, Mälarsjukhuset, Eskilstuna, Sweden; University of Uppsala, Uppsala, Sweden.

Abstract

Although dual HER2 blockade shows promising results in patients with HER2-positive breast cancer it is unclear whether this treatment strategy increases the risk for cardiac adverse events. We conducted a meta-analysis of randomized trials to investigate the risk of cardiac adverse events when a combination of anti-HER2 therapies compared to anti-HER2 monotherapy. We searched Medline, the Cochrane library, as well as the electronic abstract databases of the major international congresses' proceedings to identify randomized trials that evaluated the administration of anti-HER2 monotherapy (lapatinib or trastuzumab or pertuzumab) versus anti-HER2 combination (pertuzumab plus trastuzumab or trastuzumab plus lapatinib) therapy in breast cancer. The trials were considered eligible if the only systematic difference between the study arms was the type of anti-HER2 therapy used. Study outcomes were the congestive heart failure (CHF) grade ≥3 and left ventricular ejection fraction (LVEF) decline <50 0.26-1.27="" 0.47-1.64="" 0.53-1.48="" 0.58="" 0.88="" 0.98-2.23="" 1.49="" 10="" 2.1-4.1="" 2.2-4.4="" 2.9="" 3.1="" and="" anti-her2="" baseline.="" between="" cardiac="" chf="" ci:="" combination="" combined="" comparable="" considered="" decline="" eligible.="" evidence="" for="" from="" in="" incidence="" lvef="" meta-analysis="" monotherapy.="" monotherapy="" more="" of="" or="" overall="" p-value="0.64)." p="" provides="" respectively.="" results="" six="" supporting="" than="" the="" therapy="" this="" toxicity="" trials="" was="" were="" while="">