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01-04-2018 | Clinical trial

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)

Authors: 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 Chen, Richard Rodeheffer, Martine Piccart, Thomas Suter, Evandro de Azambuja

Published in: Breast Cancer Research and Treatment | Issue 3/2018

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 anthracycline-naïve patients receiving trastuzumab and/or lapatinib.

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Title: 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)
Authors: 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 Chen
Richard Rodeheffer
Martine Piccart
Thomas Suter
Evandro de Azambuja
Publication date: 01-04-2018
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2018
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-017-4628-3

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