Cardiac toxicities of lapatinib in patients with breast cancer and other HER2-positive cancers: a meta-analysis

Hye Duck Choi, Min Jung Chang

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Lapatinib is a tyrosine kinase inhibitor that targets the human epidermal growth factor receptor 2 (HER2) and the epidermal growth factor receptor (EGFR/HER1), and there are concerns about its cardiac toxicity. Recent studies of lapatinib have reported cardiac adverse events; however, the results have been inconsistent among the studies. The aim of our study was to estimate the cardiac toxicity of lapatinib in patients with breast cancer and other HER2-positive cancers. Methods: To evaluate the cardiotoxicity of lapatinib, the results of previous studies were quantitatively integrated using meta-analysis. Forty-five articles regarding cardiac adverse events, including left ventricular dysfunction, left ventricular ejection fraction (LVEF) decrease, arrhythmia, and other cardiac adverse events, were assessed. As a subgroup analysis in patients with breast cancer, 26 studies of lapatinib-induced cardiac adverse events were assessed. Results: The overall incidence of cardiac adverse events was 2.70% (95% confidence interval [CI] 1.60–4.50%). The incidences of left ventricular dysfunction and LVEF decrease were 1.60% (95% CI 1.30–2.00%) and 2.20% (95% CI 1.30–3.60%), respectively. The overall incidence of cardiac adverse events was 3.00% (95% CI 1.50–6.10%) in patients with breast cancer, which was marginally higher than the rate in patients with all type of cancers. Conclusion: The overall incidence of lapatinib-induced cardiac toxicity was relatively low based on an indirect comparison with trastuzumab. However, careful monitoring of cardiac toxicity is still needed when patients are treated with lapatinib because the related risk factors have not been clearly identified.

Original languageEnglish
Pages (from-to)927-936
Number of pages10
JournalBreast Cancer Research and Treatment
Volume166
Issue number3
DOIs
Publication statusPublished - 2017 Dec 1

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Meta-Analysis
Breast Neoplasms
Neoplasms
Confidence Intervals
Incidence
Left Ventricular Dysfunction
Stroke Volume
human ERBB2 protein
lapatinib
Cardiotoxicity
Epidermal Growth Factor Receptor
Protein-Tyrosine Kinases
Cardiac Arrhythmias

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

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title = "Cardiac toxicities of lapatinib in patients with breast cancer and other HER2-positive cancers: a meta-analysis",
abstract = "Purpose: Lapatinib is a tyrosine kinase inhibitor that targets the human epidermal growth factor receptor 2 (HER2) and the epidermal growth factor receptor (EGFR/HER1), and there are concerns about its cardiac toxicity. Recent studies of lapatinib have reported cardiac adverse events; however, the results have been inconsistent among the studies. The aim of our study was to estimate the cardiac toxicity of lapatinib in patients with breast cancer and other HER2-positive cancers. Methods: To evaluate the cardiotoxicity of lapatinib, the results of previous studies were quantitatively integrated using meta-analysis. Forty-five articles regarding cardiac adverse events, including left ventricular dysfunction, left ventricular ejection fraction (LVEF) decrease, arrhythmia, and other cardiac adverse events, were assessed. As a subgroup analysis in patients with breast cancer, 26 studies of lapatinib-induced cardiac adverse events were assessed. Results: The overall incidence of cardiac adverse events was 2.70{\%} (95{\%} confidence interval [CI] 1.60–4.50{\%}). The incidences of left ventricular dysfunction and LVEF decrease were 1.60{\%} (95{\%} CI 1.30–2.00{\%}) and 2.20{\%} (95{\%} CI 1.30–3.60{\%}), respectively. The overall incidence of cardiac adverse events was 3.00{\%} (95{\%} CI 1.50–6.10{\%}) in patients with breast cancer, which was marginally higher than the rate in patients with all type of cancers. Conclusion: The overall incidence of lapatinib-induced cardiac toxicity was relatively low based on an indirect comparison with trastuzumab. However, careful monitoring of cardiac toxicity is still needed when patients are treated with lapatinib because the related risk factors have not been clearly identified.",
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Cardiac toxicities of lapatinib in patients with breast cancer and other HER2-positive cancers : a meta-analysis. / Choi, Hye Duck; Chang, Min Jung.

In: Breast Cancer Research and Treatment, Vol. 166, No. 3, 01.12.2017, p. 927-936.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cardiac toxicities of lapatinib in patients with breast cancer and other HER2-positive cancers

T2 - a meta-analysis

AU - Choi, Hye Duck

AU - Chang, Min Jung

PY - 2017/12/1

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N2 - Purpose: Lapatinib is a tyrosine kinase inhibitor that targets the human epidermal growth factor receptor 2 (HER2) and the epidermal growth factor receptor (EGFR/HER1), and there are concerns about its cardiac toxicity. Recent studies of lapatinib have reported cardiac adverse events; however, the results have been inconsistent among the studies. The aim of our study was to estimate the cardiac toxicity of lapatinib in patients with breast cancer and other HER2-positive cancers. Methods: To evaluate the cardiotoxicity of lapatinib, the results of previous studies were quantitatively integrated using meta-analysis. Forty-five articles regarding cardiac adverse events, including left ventricular dysfunction, left ventricular ejection fraction (LVEF) decrease, arrhythmia, and other cardiac adverse events, were assessed. As a subgroup analysis in patients with breast cancer, 26 studies of lapatinib-induced cardiac adverse events were assessed. Results: The overall incidence of cardiac adverse events was 2.70% (95% confidence interval [CI] 1.60–4.50%). The incidences of left ventricular dysfunction and LVEF decrease were 1.60% (95% CI 1.30–2.00%) and 2.20% (95% CI 1.30–3.60%), respectively. The overall incidence of cardiac adverse events was 3.00% (95% CI 1.50–6.10%) in patients with breast cancer, which was marginally higher than the rate in patients with all type of cancers. Conclusion: The overall incidence of lapatinib-induced cardiac toxicity was relatively low based on an indirect comparison with trastuzumab. However, careful monitoring of cardiac toxicity is still needed when patients are treated with lapatinib because the related risk factors have not been clearly identified.

AB - Purpose: Lapatinib is a tyrosine kinase inhibitor that targets the human epidermal growth factor receptor 2 (HER2) and the epidermal growth factor receptor (EGFR/HER1), and there are concerns about its cardiac toxicity. Recent studies of lapatinib have reported cardiac adverse events; however, the results have been inconsistent among the studies. The aim of our study was to estimate the cardiac toxicity of lapatinib in patients with breast cancer and other HER2-positive cancers. Methods: To evaluate the cardiotoxicity of lapatinib, the results of previous studies were quantitatively integrated using meta-analysis. Forty-five articles regarding cardiac adverse events, including left ventricular dysfunction, left ventricular ejection fraction (LVEF) decrease, arrhythmia, and other cardiac adverse events, were assessed. As a subgroup analysis in patients with breast cancer, 26 studies of lapatinib-induced cardiac adverse events were assessed. Results: The overall incidence of cardiac adverse events was 2.70% (95% confidence interval [CI] 1.60–4.50%). The incidences of left ventricular dysfunction and LVEF decrease were 1.60% (95% CI 1.30–2.00%) and 2.20% (95% CI 1.30–3.60%), respectively. The overall incidence of cardiac adverse events was 3.00% (95% CI 1.50–6.10%) in patients with breast cancer, which was marginally higher than the rate in patients with all type of cancers. Conclusion: The overall incidence of lapatinib-induced cardiac toxicity was relatively low based on an indirect comparison with trastuzumab. However, careful monitoring of cardiac toxicity is still needed when patients are treated with lapatinib because the related risk factors have not been clearly identified.

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