Cardiotoxicity of Pertuzumab Containing Regimens for HER-2 Positive Breast Cancer

Abstract

Objectives: Specific Aim #1: Describe the incidence and degree of severity of cardiac dysfunction in case studies, retrospective chart analyses, and prospective randomized clinical trials for patients treated with pertuzumab containing regimens for neoadjuvant treatment of locally advanced, inflammatory, or early stage HER2+ BC, or for treatment of metastatic HER2+ BC. Specific Aim #2: Describe the frequency of cardiac safety monitoring for patients undergoing treatment with pertuzumab containing regimens for HER2+ BC within these case studies, retrospective chart analyses, and prospective randomized clinical trials. Methods: Case reports, retrospective chart analyses, and prospective, randomized, controlled trials were identified by search of PubMed and Embase databases, as well as through the Google Scholar search engine. The search strategy included the following keywords: epidermal growth factor receptor 2, erbB-2 genes, pertuzumab, cardiotoxicity, left ventricular function, and left ventricular dysfunction. Reviews were ineligible. All studies that examined the cardiac safety of pertuzumab containing regimens for chemotherapy-naïve HER2+ locally advanced, inflammatory, early stage, or metastatic breast cancer were considered eligible for this systematic review, regardless of sample size. Results: So far, the search strategy retrieved 3 studies that evaluated the cardiac toxicity outcomes of pertuzumab containing regimens. All studies were conducted for chemotherapy-naïve HER2+ locally advanced, inflammatory, early stage, or metastatic breast cancer. Conclusions: The incidence of cardiotoxicity due to treatment with pertuzumab containing regimens for chemotherapy-naïve HER2+ locally advanced, inflammatory, early stage, or metastatic breast cancer remains relatively low. However, the potential severity of cardiac effects related to pertuzumab containing regimens is an important consideration when using these regimens in patients who have any existing risk factors for decreased cardiac function. This systematic review providers a more thorough understanding of the incidence and severity of cardiac adverse effects related to pertuzumab containing regimens since the time pertuzumab was first introduced as an option for HER2+ breast cancer patients.