Incidence of CHF
A total of 6,818 patients receiving dual HER-2 blockade in 14 RCTs were available for CHF analysis. There were 56 total CHF events among these patients. The highest incidence (2.0%; 95% CI 0.7 to 6.1%) was observed in a phase III breast cancer trial of trastuzumab plus lapatinib after prior trastuzumab-based therapies[33], while no events of CHF occurred in five trials. Using a fixed-effects model (χ2-based Q statistic test: Q=8.26; p =0.82; I 2=0%), the summary incidence of CHF in cancer patients treated with dual HER2 blockade was 0.9% (95% CI, 0.7% to 1.2%, figure 2C). As for CHF associated with anti-HER2 monotherapy, a total of 9,283 patients were included for analysis. Using a random-effects model (χ2-based Q statistic test: Q=52.77; p <0.001;I 2 =73.42%), the summary incidence of CHF in cancer patients treated with anti- HER2 monotherapy was 0.7% (95% CI, 0.4% to 1.3%, figure 2D).