Key result
HFA-ICOS risk score shows modest discrimination for cancer therapy-related cardiotoxicity with ~0.64 AUC.
Why the study?
The study sought to validate the HFA-ICOS risk score for predicting anticancer therapy-induced cardiotoxicity in HER2-positive breast cancer patients.
Does the HFA-ICOS risk score accurately predict cancer therapy-related cardiotoxicity in patients with HER2-positive breast cancer?
Cohort (n=507)
No
Does the HFA-ICOS risk score accurately predict cancer therapy-related cardiotoxicity in patients with HER2-positive breast cancer?
The HFA-ICOS risk score has moderate overall predictive power but excellent negative predictive value for identifying cardiotoxicity risk in HER2-positive breast cancer patients on trastuzumab regimens.
High NPV may support reduced surveillance in low-risk HER2+ patients; leaves open prospective validation and refinement.
BACKGROUND: This paper looks to validate the risk score from the Heart Failure Association of the European Society of Cardiology and the International Cardio-Oncology Society (HFA-ICOS) for predicting potential cardiotoxicity from anticancer therapy for patients positive for human epidermal growth factor receptor 2. METHODS: A total of 507 patients with at least five years since index diagnosis of breast cancer were retrospectively divided according to the HFA-ICOS risk proforma. According to level of risk, these groups were assessed for rates of cardiotoxicity via mixed-effect Bayesian logistic regression model. RESULTS: = 6) in the very-high-risk groups respectively. For cardiac events related to treatment, the risk was significantly higher for the very-high-risk category of HFA-ICOS compared to other categories (Beta = 3.1, 95% CrI: 1.5, 4.8). For overall cardiotoxicity related to treatment, the area under the curve was 0.643 (CI 95%: 0.51, 0.76), with 26.1% (95% CI: 8%, 44%) sensitivity and 97.9% (95% CI: 96%, 99%) specificity. CONCLUSIONS: The HFA-ICOS risk score has moderate power in predicting cancer therapy-related cardiotoxicity in HER2-positive breast cancer patients.
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Cronin et al. (2023) conducted a cohort in HER2-Positive Breast Cancer (n=507). HFA-ICOS very-high-risk category vs. Low, medium, and high HFA-ICOS risk categories was evaluated on Overall cardiotoxicity related to treatment (AUC 0.643, 95% CI 0.51-0.76). The HFA-ICOS risk score demonstrated moderate predictive power for cancer therapy-related cardiotoxicity with an AUC of 0.643, carrying excellent negative predictive power.
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