Cardiotoxic Effects of Antibody Drug Conjugates vs Standard Chemotherapy in -Positive Advanced Breast Cancer

What is the incidence of cardiotoxic effects of novel antibody-drug conjugates compared with the standard-of-care chemotherapy regimens containing trastuzumab for -positive locally advanced or metastatic breast cancer?In this systematic review and meta-analysis of 9538 patients, a pooled analysis demonstrated a 0.94% incidence of left ventricular ejection fraction (LVEF) decrease with trastuzumab emtansine, a 4.20% incidence of LVEF decrease with trastuzumab deruxtecan, a 4.85% incidence of LVEF decrease with trastuzumab plus chemotherapy, and a 5.52% incidence of LVEF decrease with trastuzumab, pertuzumab, and chemotherapy.Trastuzumab emtansine had the lowest incidence of LVEF decrease, and trastuzumab deruxtecan, trastuzumab plus chemotherapy, and trastuzumab plus pertuzumab plus chemotherapy had similar incidences of LVEF decrease; however, more research regarding their cardiotoxic effects is needed.

Corresponding Author: Avirup Guha, MD, MPH, Department of Medicine, Division of Cardiology, Medical College of Georgia at Augusta University, 1410 Laney Walker Blvd, CN 5313, Augusta, GA 30912 (aguha@augusta.edu).

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