Key result
Pertuzumab therapy is linked to a low ~1.7% cardiotoxicity rate in HER2-positive breast cancer.
Why the study?
Real life data on pertuzumab-induced cardiotoxicity are limited, raising concerns about additive cardiac risk when combined with trastuzumab.
Does the addition of pertuzumab to trastuzumab increase the risk of cardiotoxicity in patients with breast cancer?
Observational (n=118)
No
Does the addition of pertuzumab to trastuzumab increase the risk of cardiotoxicity in patients with breast cancer?
In a real-world single-center cohort, the addition of pertuzumab to trastuzumab in breast cancer patients was associated with a low incidence of cardiotoxicity (1.69%), consistent with expected rates for trastuzumab alone.
Supports real-world cardiac safety of pertuzumab addition; hypothesis-generating and leaves open randomized confirmation of added risk.
Pertuzumab-mediated Cardiotoxicity: A Single Center Study. Objective: Recent clinical trials have shown that adding pertuzumab to trastuzumab improved the cellular response to therapy and provides a survival benefit compared with trastuzumab alone. However, it has raised concerns about additive risk of cardiotoxicity. Real life data on pertuzumab-induced cardiotoxicity are limited. Materials and Methods: Patients a diagnosis of breast cancer who had been treated trastuzumab plus pertuzumab between January 2017 and June 2022 and had undergone regularly transthoracic echocardiography, as a part of control visits, in our medical center were included. We performed descriptive statistical analysis to evaluate the patients’ characteristics and therapies, which could increase the risk of cardiac adverse events. Cardiotoxicity was evaluated by serial left ventricular ejection fraction (LVEF) measuring by 2D echocardiography at baseline and every three months during pertuzumab therapy and was defined as a decrease in LVEF > 10% to below 55%. Results: There were 118 patients fulfilling the inclusion criteria. The median age of the population was 51 (41-60) years. The median duration of pertuzumab therapy was 15 (9–57) weeks. Pertuzumab therapy was discontinued in two patients because of an allergic reaction and in other two patients due to cardiotoxicity. The reduced LVEF did not recover to baseline values in either patient. Conclusion: The incidence of cardiotoxicity (1.69%) in the current study was no higher than expected for trastuzumab alone. Data from previous studies and the results of this study support that pertuzumab causes no increase in cardiotoxicity. Still, large clinical trials are needed to verify the cardiac safety of pertuzumab in a real-world setting.
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Acıbuca et al. (2023) conducted an observational in HER2-positive breast cancer (n=118). Pertuzumab was evaluated on Cardiotoxicity (decrease in LVEF > 10% to below 55%). Pertuzumab therapy in patients with HER2-positive breast cancer was associated with a low incidence of cardiotoxicity (1.69%), supporting its cardiac safety in a real-world setting.
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