Kantonsspital St.Gallen
login

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 Chen, Richard Rodeheffer, Martine Piccart, Thomas Suter & Evandro De Azambuja

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.
   
citation 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, Chen D R, Rodeheffer R, Piccart M, Suter T, de Azambuja E. 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 Res Treat 2017; 168:631-638.
   
type journal paper/review (English)
date of publishing 27-12-2017
journal title Breast Cancer Res Treat (168/3)
ISSN electronic 1573-7217
pages 631-638
PubMed 29280043
DOI 10.1007/s10549-017-4628-3