de Azambuja, E; Agostinetto, E; Procter, M; Eiger, D; Pondé, N; Guillaume, S; Parlier, D; Lambertini, M; Desmet, A; Caballero, C; Aguila, C; Jerusalem, G; Walshe, J M; Frank, E; Bines, J; Loibl, S; Piccart-Gebhart, M; Ewer, M S; Dent, S; Plummer, C; ... (2023). Cardiac safety of dual anti-HER2 blockade with pertuzumab plus trastuzumab in early HER2-positive breast cancer in the APHINITY trial. ESMO open, 8(1), p. 100772. BMJ 10.1016/j.esmoop.2022.100772 <http://dx.doi.org/10.1016/j.esmoop.2022.100772Test>
BACKGROUND Trastuzumab increases the incidence of cardiac events (CEs) in patients with breast cancer (BC). Dual blockade with pertuzumab (P) and trastuzumab (T) improves BC outcomes and is the standard of care for high-risk human epidermal growth factor receptor 2 (HER2)-positive early BC patients. We analyzed the cardiac safety of P and T in the phase III APHINITY trial. PATIENTS AND METHODS Left ventricular ejection fraction (LVEF) ≥ 55% was required at study entry. LVEF assessment was carried out every 3 months during treatment, every 6 months up to month 36, and yearly up to 10 years. Primary CE was defined as heart failure class III/IV and a significant decrease in LVEF (defined as ≥10% from baseline and to 65 years, body mass index ≥ 25 kg/m2, baseline LVEF between 55% and
