Abstract 1832P
Background
Approximately 15–20% of breast cancers (BC) overexpress the HER2 receptor (HER2+). The introduction of anti-HER2 therapies to the treatment of BC HER2+ has brought about a revolution in terms of survival and quality of life. However, some of these treatments have also led to an increase of cardiotoxicity at expense of decrease the left ventricular function (LVEF). Meanwhile, pertuzumab (PER) has not been shown to increase the risk of cardiac events. The aim of this study is to evaluate the existence of an increase in cardiotoxicity associated with PER treatments in BC HER2+ via a systematic review.
Methods
A systematic review was carried out according to PRISMA criteria based on clinical trials in BC HER2+ in all stages that included first-line PER treatment in either arm. The clinical trials included studies conducted between 1 January 2005 and 31 December 2020. The flow diagram included 459 articles, of which only 25 were ultimately selected. The statistical analysis was expressed in terms of the number of cardiac events, LVEF and deaths of cardiac origin. Statistical analysis was performed with SPSSv25.
Results
Of the 25 clinical trials evaluated, 10 addressed metastatic stages of BC, 14 focussed on localised BC and one BC in all stages. The total number of patients (pts) evaluated was 11,678, of which 7,768 (66,52%) belonged to PER-receiving groups and 3,910 (33,48%) were members of control groups. The numbers of cardiac events were 176 (2,31%) in the PER groups and 48 (1,23%) in groups without PER. LVEF was observed more frequently in groups with PER (179 events, 2,3%), compared to groups without PER (55 events, 1,41%), with the differences observed in pts with PER in localised, versus metastatic, stages of BC. The number of cardiac deaths was 12 (0,15%) among those given PER and 2 (0,05%) among without PER.
Conclusions
Despite the limitation of having no data on clinical trials directed toward the study of cardiotoxicity with PER, our study showed a higher tendency for BC HER2+ treatments with PER to present greater cardiotoxicity. Clinical trials in this field evaluating the true effect of these treatments on cardiac toxicity will be necessary to demonstrate our conclusions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.