Meta-analysis of cardiotoxic effects of antibody-drug conjugates versus standard chemotherapy in HER2-positive advanced breast cancer

Systematic review and meta-analysis of published studies evaluated cardiotoxic effects of antibody-drug conjugates compared to standard chemotherapy in patients with HER2-positive locally advanced or metastatic breast cancer. Twenty-one phase 3 studies (n=9538 patients) were included in the meta-analysis. The analysis found 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 LVEGF decrease with trastuzumab, pertuzumab, and chemotherapy. The authors conclude that trastuzumab emtansine had the lowest incidence of LVEF decrease.