Published April 27, 2018 | Version v.1
Journal article Open

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)

  • 1. Breast Cancer Research Laboratory, Department of Medicine, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Blvd de Waterloo 121, Brussels, Belgium
  • 2. Frontier Science (Scotland) Ltd., Grampian View, Kingussie, PH21 1NA, UK
  • 3. Breast Cancer Research Laboratory, Department of Medicine, Institut Jules Bordet and L'Université Libre de Bruxelles (U.L.B), Blvd de Waterloo 121, Brussels, Belgium.
  • 4. MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA.
  • 5. Frontier Science (Scotland) Ltd., Grampian View, Kingussie, PH21 1NA, UK.
  • 6. Breast International Group, Boulevard de Waterloo 76, 1000, Brussels, Belgium.
  • 7. Istituto Nazionale del Tumori, Via Giacomo Venezian, 1, 20133, Milan, Italy.
  • 8. Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, USA ; SOLTI Breast Cancer Research Group, Barcelona, Spain
  • 9. Breast Center, University of Ulm, Helmholtzstraße 16, 89081, Ulm, Germany.
  • 10. Oncology Clinical Development, Oncology Business Unit, Novartis Pharma AG, Klybeckstrasse, 4057, Basel, Switzerland.
  • 11. Institute for Oncology and Radiology of Serbia, National Cancer Research Center University of Belgrade, Pasterova 14, Belgrade, Serbia
  • 12. Brustzentrum, Frauenklinik der Universität München, Klinikum der Universität München, Maistraße 11, Munich, Germany.
  • 13. Allgemeines Krankenhaus Celle, Siemenspl. 4, 29223, Celle, Germany
  • 14. Samsung Medical Center, 81 Irwon-ro, Irwon-dong, Gangnam-gu, Seoul, South Korea.
  • 15. Hospital Virgen del Rocio, Avenida Manuel Siurot, S/N, 41013, Seville, Spain.
  • 16. Changhua Christian Hospital, No. 176, Zhonghua Road, Changhua City, Changhua County, Taiwan, 500.
  • 17. Mayo Clinic, 200 1st St SW, Rochester, MN, USA.
  • 18. Swiss Cardiovascular Center, Inselspital, Bern University Hospital, Freiburgstrasse 8, 3010, Bern, Switzerland

Description

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.

Notes

This research has received research grant from "Les Amis de L'Institut Bordet" (Grant 2016-02). 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). This work was partially presented at the San Antonio Breast Cancer 2016 (abstract # P4-21-09)

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Cardiac biomarkers for early detection and prediction of trastuzumab and..or lapatinib.pdf

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Is identical to
29280043 (PMID)
Is part of
0167-6806 (ISSN)
1573-7217 (ISSN)