Real-world data analysis of Anti-HER2 therapy–induced cardiotoxicity in breast cancer patients: A multi-center experience from the Middle East.

Abstract

e24003 Background: HER2 inhibitors have revolutionized the treatment of HER2-positive breast cancer, significantly improving survival outcomes. However, cardiotoxicity remains a significant concern, potentially limiting the benefits of these life-saving therapies. This study aimed to investigate the incidence and characteristics of cardiotoxicity in HER2-positive breast cancer patients treated with HER2 inhibitors including new antibody drug conjugate within a real-world setting at Middle East, Saudi Arabia. Methods: This was a retrospective, multicenter study encompassing adult patients with HR+/-, HER2-positive breast cancer who received HER2-targeted therapies at National Guard-affiliated hospitals and King Fahad Medical City. The primary objective was to determine the incidence and onset of cardiotoxicity associated with HER2 inhibitor treatment. Descriptive statistical analyses were performed using STATA Version 18.5. Results: A total of 497 patients were included in the analysis. The cohort predominantly comprised stage IV (49.3%) patients with a median age of 53 years. Common comorbidities included hypertension (38.4%) and diabetes (29%). The most frequent treatment regimen consisted of dual HER2 inhibitors; trastuzumab and pertuzumab (62.8%). Cardiotoxicity was observed in 8.3% of patients, primarily manifesting as a reduction in left ventricular ejection fraction (90%). The median time to cardiotoxicity onset was 6.64 months. Importantly, most cardiotoxicity events were reversible (82.5%), and proactive cardiology intervention was crucial in successful management (97.2%). Disease progression occurred in 32.6% of patients, but no patient experienced cardiotoxicity-related death. Conclusions: This real-world study demonstrates a manageable rate of cardiotoxicity in HER2-positive breast cancer patients receiving HER-2 inhibitors-based therapies in Saudi Arabia. Early detection and close monitoring with cardiology specialists are essential for timely intervention and optimal patient outcomes.