Evidence map›Paper›PMID 34940066›Full record

Trial reportCurrent oncology (Toronto, Ont.)2021

A Randomized Trial Comparing 3- versus 4-Monthly Cardiac Monitoring in Patients Receiving Trastuzumab-Based Chemotherapy for Early Breast Cancer.

Susan Dent, Dean Fergusson, Olexiy Aseyev, Carol Stober, Gregory Pond, Arif A Awan, Sharon F McGee, Terry L Ng, Demetrios Simos, Lisa Vandermeer and 4 more

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Current oncology (Toronto, Ont.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02696707 (An Integrated Consent Model Study to Compare Two Standard of Care Schedules for Monitoring Cardiac Function in Patients Receiving Trastuzumab for Early Stage Breast Cancer), which is not on this map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02696707 phase4completednot on this map

An Integrated Consent Model Study to Compare Two Standard of Care Schedules for Monitoring Cardiac Function in Patients Receiving Trastuzumab for Early Stage Breast Cancer

TypeinterventionalSponsorOttawa Hospital Research InstituteRan2016 to 2020Enrolled200ConditionsBreast CancerArmsLVEF 3 month, LVEF 4 month
3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 5 institutions in 1 country.

Susan DentDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Dean FergussonClinical Epidemiology Program, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Olexiy AseyevThunder Bay Regional Cancer Care Northwest, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON P7B 6V4, Canada.
Carol StoberCancer Therapeutics Program, The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
Gregory PondDepartment of Oncology, McMaster University, Hamilton, ON L8S 4L8, Canada.
Arif A AwanDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Sharon F McGeeDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Terry L NgDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Demetrios SimosStronach Regional Cancer Center, Southlake Regional Health Care Centre, Newmarket, ON L3Y 2P9, Canada.
Lisa VandermeerCancer Therapeutics Program, The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
Deanna SaundersCancer Therapeutics Program, The Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada.
John F HiltonDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Brian HuttonClinical Epidemiology Program, The Ottawa Hospital Research Institute, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Mark ClemonsDivision of Medical Oncology, Department of Medicine, The Ottawa Hospital, The University of Ottawa, Ottawa, ON K1H 8L6, Canada.ORCID 0000-0001-9392-8219
University of Ottawa · CAOttawa Hospital · CAMcMaster University · CASouthlake Regional Health Center · CAThunder Bay Regional Health Sciences Centre · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe optimal frequency for cardiac monitoring of left ventricular ejection fraction (LVEF) in patients receiving trastuzumab-based therapy for early breast cancer (EBC) is unknown. We conducted a randomized controlled trial comparing 3- versus 4-monthly cardiac monitoring. PATIENTS AND

methodPatients scheduled to receive trastuzumab-containing cancer therapy for EBC with normal (>53%) baseline LVEF were randomized to undergo LVEF assessments every 3 or 4 months. The primary outcome was the change in LVEF from baseline. Secondary outcomes included the rate of cardiac dysfunction (defined as a decrease in the LVEF of ≥10 percentage points, to a value <53%), delays in or discontinuation of trastuzumab therapy, and cardiology referral.

resultsOf the 200 eligible and enrolled patients, 100 (50%) were randomized to 3-monthly and 100 (50%) to 4-monthly cardiac monitoring. Of these patients, 98 and 97 respectively underwent at least one cardiac scan. The estimated mean difference in LVEF from baseline was -0.94% (one-sided 95% lower bound: -2.14), which exceeded the pre-defined non-inferiority margin of -4%. There were also no significant differences between the two study arms for any of the secondary endpoints. The rate of detection of cardiac dysfunction was 16.3% (16/98) and 12.4% (12/97) in the 3- and 4-monthly arms, respectively (95% CI: 4.0 [-5.9, 13.8]).

conclusionsCardiac monitoring every 4 months was deemed non-inferior to that every 3 months in patients with HER2-positive EBC being treated with trastuzumab-based therapy. Given its costs and inconvenience, cardiac monitoring every 4 months should be considered standard practice. Registration: NCT02696707, 18 February 2016.

Indexed as

Breast NeoplasmsErb-b2 Receptor Tyrosine KinasesFemaleHumansStroke VolumeTrastuzumabVentricular Function, LeftErb-b2 Receptor Tyrosine KinasesTrastuzumabbreast cancercardiac monitoringtrastuzumab

Identifiers

PMID34940066
PMCPMC8700071
OpenAlexW4200378983

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.