Pooled analysis of cardiac safety in patients with cancer treated with pertuzumab
Background:
Pertuzumab, a human epidermal growth factor receptor (HER) 2 dimerization inhibitor, has demonstrated promising efficacy in combination with trastuzumab in patients with metastatic breast cancer. As HER signaling pathways are not only involved in oncogenesis, but also in myocardial homeostasis, an analysis of cardiac safety data was undertaken in a large group of patients treated with pertuzumab.
Patients And Methods:
A complete database of patients treated with full-dose pertuzumab was used to describe the incidence of asymptomatic left ventricular systolic dysfunction (LVSD) and symptomatic heart failure (HF).
Results:
Information for 598 unique patients was available for the current analysis. Of the patients treated with pertuzumab alone (n = 331) or pertuzumab in combination with a non-anthracycline-containing cytotoxic (n = 175) or trastuzumab (n = 93), 23 (6.9%), 6 (3.4%), and 6 (6.5%), respectively, developed asymptomatic LVSD and 1 (0.3%), 2 (1.1%), and 1 (1.1%), respectively, displayed symptomatic HF. None of the 15 patients receiving both pertuzumab and erlotinib demonstrated LVSD.
Conclusions:
Patients treated with pertuzumab experienced relatively low levels of asymptomatic LVSD or symptomatic HF. There was no notable increase in cardiac side-effects when pertuzumab was given in combination with other anticancer agents.
Insights
Pertuzumab treatment showed low rates of cardiac issues like left ventricular systolic dysfunction (LVSD) and heart failure (HF) in breast cancer patients. Combining pertuzumab with other agents did not significantly increase cardiac side-effects.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Pertuzumab is a HER2 dimerization inhibitor effective in metastatic breast cancer.
- HER signaling impacts both cancer growth and heart function.
- Cardiac safety evaluation is crucial for pertuzumab therapy.
Purpose of the Study:
- To assess cardiac safety in patients receiving pertuzumab.
- To determine the incidence of left ventricular systolic dysfunction (LVSD) and heart failure (HF).
Main Methods:
- Analysis of a comprehensive database of patients treated with full-dose pertuzumab.
- Evaluation of cardiac events including asymptomatic LVSD and symptomatic HF.
- Categorization of patients based on concurrent treatments (pertuzumab alone, with cytotoxic agents, or with trastuzumab).
Main Results:
- Low incidence of asymptomatic LVSD (6.9% alone, 3.4% with cytotoxic, 6.5% with trastuzumab).
- Low incidence of symptomatic heart failure (HF) (0.3% alone, 1.1% with cytotoxic, 1.1% with trastuzumab).
- No LVSD observed in patients receiving pertuzumab with erlotinib.
Conclusions:
- Pertuzumab treatment is associated with low levels of cardiac dysfunction (LVSD) and heart failure (HF).
- Combination therapy with pertuzumab and other anticancer agents did not elevate cardiac risks.
- Pertuzumab demonstrates a favorable cardiac safety profile in breast cancer patients.
