Edith Mari G. Timbol (Philippines)
University of the Philippines - Philippine General Hospital Department of MedicineAuthor of 1 Presentation
EFFICACY OF BETA-BLOCKERS IN PREVENTING TRASTUZUMAB-INDUCED CARDIOTOXICITY AMONG ADULT BREAST CANCER PATIENTS
Abstract
Background and Aims
Cardiac dysfunction is a significant toxicity associated with HER2-directed therapy - the risk for which can be increased by concomitant or antecedent exposure to other cardiotoxic agents particularly anthracyclines. This study sought to assess the efficacy of beta-blockers in preventing trastuzumab-induced cardiotoxicity.
Methods
A systematic search using MEDLINE, SCOPUS, CENTRAL, and Europe PMC databases was conducted until October 11, 2020. Included were randomized controlled trials of adult breast cancer patients on trastuzumab therapy and given beta-blockers (versus placebo). The primary outcome was a change in left ventricular ejection fraction (LVEF) from baseline to end of study. Secondary outcomes measured were changes in cardiac biomarkers (e.g. BNP), and safety. Validity of included studies was assessed using the Cochrane Risk-of-Bias tool. Pooled estimates for each outcome were reported as weighted mean differences.
Results
We identified 3 published trials (N=396). Beta-blocker therapy was associated with significantly higher LVEF on follow-up versus placebo (Mean Difference 1.84; 95% CI: 0.36-3.32; P=0.01; I²=63%). There was a trend toward benefit in the prevention of marked increases in BNP among those treated with beta-blockers versus placebo (Mean Difference 2.40; 95% CI: -1.70-5.87; P=0.18; I²=47%). A narrative description of adverse cardiac events and other cardiac imaging parameters was reported as well.
Conclusions
Beta-blockers appear to be well-tolerated and effective in preventing trastuzumab-induced cardiotoxicity, as well as in potentially attenuating elevations in serum BNP levels among adult breast cancer patients.
Presenter of 1 Presentation
EFFICACY OF BETA-BLOCKERS IN PREVENTING TRASTUZUMAB-INDUCED CARDIOTOXICITY AMONG ADULT BREAST CANCER PATIENTS
Abstract
Background and Aims
Cardiac dysfunction is a significant toxicity associated with HER2-directed therapy - the risk for which can be increased by concomitant or antecedent exposure to other cardiotoxic agents particularly anthracyclines. This study sought to assess the efficacy of beta-blockers in preventing trastuzumab-induced cardiotoxicity.
Methods
A systematic search using MEDLINE, SCOPUS, CENTRAL, and Europe PMC databases was conducted until October 11, 2020. Included were randomized controlled trials of adult breast cancer patients on trastuzumab therapy and given beta-blockers (versus placebo). The primary outcome was a change in left ventricular ejection fraction (LVEF) from baseline to end of study. Secondary outcomes measured were changes in cardiac biomarkers (e.g. BNP), and safety. Validity of included studies was assessed using the Cochrane Risk-of-Bias tool. Pooled estimates for each outcome were reported as weighted mean differences.
Results
We identified 3 published trials (N=396). Beta-blocker therapy was associated with significantly higher LVEF on follow-up versus placebo (Mean Difference 1.84; 95% CI: 0.36-3.32; P=0.01; I²=63%). There was a trend toward benefit in the prevention of marked increases in BNP among those treated with beta-blockers versus placebo (Mean Difference 2.40; 95% CI: -1.70-5.87; P=0.18; I²=47%). A narrative description of adverse cardiac events and other cardiac imaging parameters was reported as well.
Conclusions
Beta-blockers appear to be well-tolerated and effective in preventing trastuzumab-induced cardiotoxicity, as well as in potentially attenuating elevations in serum BNP levels among adult breast cancer patients.