Applications of cardiotoxicity in breast cancer: a meta-analysis.
BACKGROUND
Breast cancer is the most common type of cancer in women. Many antineoplastic agents used to treat breast cancer have potentially cardiotoxic effects and may lead to chemotherapy induced cardiomyopathy and heart failure. We conducted a meta-analysis to clarify the applications of cardiotoxicity in breast cancer.


METHODS
A published literature search was performed through PubMed, Cochrane Library, Medline, and Science Citation Index Expanded databases for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random or fixed effects models. Heterogeneity was assessed using χ2 and I2 statistics. We performed a formal meta-analysis using summary measures from these studies.


RESULTS
In total, 9 published studies were included in the final analysis. The combined analysis revealed that there was non-significant regardless of the statistical ejection fraction (OR=0.98, 95% CI: 0.63-1.54, P=0.96) and left ventricular ejection fraction (OR=1.04; 95% CI: 0.69-1.56, P=0.85) decline method used. Additionally, the pooled OR was 0.99 (95% CI: 0.79-1.28) for the trastuzumab plus lapatinib combination, and 1.00 (95% CI: 0.88-1.13) for the trastuzumab plus pertuzumab combination.


CONCLUSIONS
In this meta-analysis, there was evidence indicated that there was not a significant decrease on LVEF and EF in patients who received trastuzumab plus lapatinib and trastuzumab plus pertuzumab combination. Our study suggests that the combination of two anti-HER2 agents does not significantly increase the risk for adverse compared with anti-HER2 monotherapy in patients with adequate cardiac function prior to start of therapy.
Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Hossein
H
Rahmani
Laboratory of Proteomics, Chemical Injuries Research Center, and Department of Physiology and Biophysics, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Alireza
A
Shahriary
Department of Cardiac Surgery, Atherosclerosis Research Center, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran - mohammadalisheikhi2016@gmail.com.
Mohammad A
MA
Sheikhi
Department of Cardiac Anesthesiology, Golestan Hospital, Atherosclerosis Research Center, Pain Research Center, Ahvaz Jundishapur University, Ahvaz, Iran.
Ahmad
A
Ebadi
Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Hannaneh
H
Davoodzadeh
D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy*; D066126:Cardiotoxicity / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000077341:Lapatinib; D016017:Odds Ratio; D011799:Quinazolines / Q000008:administration & dosage; D012306:Risk; D000068878:Trastuzumab / Q000008:administration & dosage; D016277:Ventricular Function, Left / Q000187:drug effects
D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D011799:Quinazolines; D000077341:Lapatinib; C485206:pertuzumab; D000068878:Trastuzumab