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).

Ponde, NoamBradbury, IanLambertini, MatteoEwer, MichaelCampbell, ChristineAmeels, HeleneZardavas, DimitriosDi Cosimo, SerenaBaselga, JoséHuober, JensIzquierdo, MiguelFumagalli, DeboraBozovic-Spasojevic, IvanaMaetens, MarionHarbeck, NadiaPusztai, LajosBerghorn, MichaelIm, Young-HyuckBorrego, Manuel RuizChen, Dar-RenRodeheffer, RichardPiccart, MartineSuter, Thomasde Azambuja, Evandro2023-01-252023-01-252017-12-27http://hdl.handle.net/10668/11951Biomarkers 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. 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. 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. 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.enBrain natriuretic peptideCardiotoxicityHER2 positive breast cancerLapatinibTroponin TAgedBiomarkersBreast NeoplasmsCardiotoxicityCardiovascular AbnormalitiesDrug-Related Side Effects and Adverse ReactionsFemaleHumansLapatinibMiddle AgedNatriuretic Peptide, BrainNeoplasm StagingPaclitaxelReceptor, ErbB-2TrastuzumabTroponin TCardiac 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).research article29280043open access10.1007/s10549-017-4628-31573-7217PMC5843537https://europepmc.org/articles/pmc5843537?pdf=renderhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5843537/pdf