Ming Yuan1, Gary Tse2,3, Zhiwei Zhang1, Xu Han4, William K K Wu5, Guangping Li1, Yunlong Xia4, Tong Liu1. 1. Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. 2. Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, SAR, China. 3. Li Ka Shing Institute of Health Sciences, Chinese University of Hong Kong, Hong Kong, SAR, China. 4. Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, China. 5. Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Abstract
AIM: Cases of cardiotoxicity related to trastuzumab have been reported. This systematic review and meta-analysis evaluated the risk of atrial fibrillation (AF) in patients of breast cancer treated with trastuzumab. METHODS: PubMed and EMBASE were searched until September 2017 for articles that investigated AF incidence in patients receiving trastuzumab for breast cancer. RESULTS: A total of 15 studies involving 8124 patients treated with trastuzumab were included. Of the total cohort, 37 patients suffered from AF, giving rise to an incidence of 1.22% (95% confidence interval [CI]: 0.56%-2.68%). No significant difference in the incidence of AF was found between ado-trastuzumab emtansine (0.95%, 95% CI: 0.36%-2.52%) and trastuzumab groups (1.32%, 95% CI: 0.52%-3.34%), trastuzumab combined with other antineoplastic agents (2.09%, 95% CI: 1.16%-3.73%) and trastuzumab alone (0.36%, 95% CI: 0.04%-3.08%), prior exposure to anthracyclines (1.72%, 95% CI: 0.75%-3.88%) and no prior exposure (1.03%, 95% CI: 0.30%-3.51%), and radiotherapy (1.26%, 95% CI: 0.68%-2.33%) vs. no radiotherapy (1.21%, 95% CI: 0.35%-4.14%). CONCLUSIONS: Atrial fibrillation incidence in breast cancer patients receiving trastuzumab was around 1.2%. It was not influenced by the formulation of trastuzumab, the additional use of neoplastic agents, anthracycline exposure status, or concurrent radiotherapy.
AIM: Cases of cardiotoxicity related to trastuzumab have been reported. This systematic review and meta-analysis evaluated the risk of atrial fibrillation (AF) in patients of breast cancer treated with trastuzumab. METHODS: PubMed and EMBASE were searched until September 2017 for articles that investigated AF incidence in patients receiving trastuzumab for breast cancer. RESULTS: A total of 15 studies involving 8124 patients treated with trastuzumab were included. Of the total cohort, 37 patients suffered from AF, giving rise to an incidence of 1.22% (95% confidence interval [CI]: 0.56%-2.68%). No significant difference in the incidence of AF was found between ado-trastuzumab emtansine (0.95%, 95% CI: 0.36%-2.52%) and trastuzumab groups (1.32%, 95% CI: 0.52%-3.34%), trastuzumab combined with other antineoplastic agents (2.09%, 95% CI: 1.16%-3.73%) and trastuzumab alone (0.36%, 95% CI: 0.04%-3.08%), prior exposure to anthracyclines (1.72%, 95% CI: 0.75%-3.88%) and no prior exposure (1.03%, 95% CI: 0.30%-3.51%), and radiotherapy (1.26%, 95% CI: 0.68%-2.33%) vs. no radiotherapy (1.21%, 95% CI: 0.35%-4.14%). CONCLUSIONS:Atrial fibrillation incidence in breast cancerpatients receiving trastuzumab was around 1.2%. It was not influenced by the formulation of trastuzumab, the additional use of neoplastic agents, anthracycline exposure status, or concurrent radiotherapy.