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. 2015 Nov 23;34(10):1034–1042. doi: 10.1200/JCO.2015.62.1797

Table 2.

Adverse Events With Special Focus on the Most Frequent Ones (Safety Population)

Event L+T 
(n = 2,061) T→L 
(n = 2,076) L 
(n = 2,057) T 
(n = 2,076)
Adverse event, No. (%)
 Patients with at least one grade 3-4 event 944 (46) 666 (32) 840 (41) 512 (25)
 Patients with at least one serious adverse event 430 (21) 352 (17) 431 (21) 292 (14)
 Fatal adverse events 9 (< 1) 14 (< 1) 15 (< 1) 9 (< 1)
 Treatment withdrawals for toxicity 482 (23) 262 (13) 314 (15) 169 (8)
Cardiac events, No. (%)
 Symptomatic CHF, including severe CHF (NYHA class II, III, IV) 68 (3) 37 (2) 37 (2) 53 (3)
 Severe CHF (NYHA class III, IV) 22 (1) 4 (< 1) 6 (< 1) 18 (1)
 LVEF ≥ 10 decrease and ≥ LLN (based on worst case on therapy) 456 (23) 330 (17) 366 (19) 403 (20)
 LVEF ≥ 10 decrease and < LLN (based on worst case on therapy) 103 (5) 57 (3) 63 (3) 97 (5)
 Primary cardiac end point 20 (< 1) 5 (< 1) 7 (< 1) 18 (< 1)
 Any cardiac end point 77 (4) 50 (2) 39 (2) 94 (5)
Adverse events of special interest
 Diarrhea grade 3-4 315 (15) 100 (5) 233 (11) 27 (1)
 Rash/skin toxicity grade 3-4 100 (5) 80 (4) 126 (6) 12 (1)
 Hepatobiliary grade 3-4 71 (3) 54 (3) 90 (4) 16 (1)

Abbreviations: L+T, lapatinib plus trastuzumab; T→L, trastuzumab followed by lapatinib; L, lapatinib; T, trastuzumab; CHF, congestive heart failure; NYHA, New York Heart Association; LVEF, left ventricular ejection fraction; LLN, lower limit of normal.