Dapagliflozin significantly preserved ejection fraction and reduced radial and longitudinal strain impairment in mice treated with doxorubicin and a HER-2 inhibitor (p < 0.001).
Does dapagliflozin prevent cardiac dysfunction and injury in a preclinical mouse model of sequential doxorubicin and HER-2 inhibitor therapy?
Dapagliflozin effectively mitigates early cardiac dysfunction and biomarker evidence of injury in a preclinical model of sequential anthracycline and HER-2 inhibitor therapy, suggesting a potential cardioprotective role in cardio-oncology.
p-value: p=<0.001
Anthracyclines and human epidermal growth factor receptor 2 (HER-2) inhibitors are cornerstone therapies for breast cancer but are associated with significant cardiotoxicity. While sodium–glucose cotransporter 2 (SGLT2) inhibitors such as dapagliflozin have demonstrated cardio–renal protective effects during anthracycline treatment, their efficacy in preventing cardiotoxicity from sequential anthracycline and HER-2 blockade remains poorly understood. This study investigates the cardioprotective role of dapagliflozin in a preclinical model of chemotherapy-induced cardiotoxicity. Female C57Bl/6 mice were divided into four groups and treated for 10 days as follows: (1) a normal control group receiving saline (sham); (2) a model control group receiving doxorubicin (2.17 mg/kg/day for 5 days) followed by HER-2-blocking monoclonal antibody (2.25 mg/kg/day for 5 days); (3) a dapagliflozin-only group (10 mg/kg/day via oral gavage); and (4) a treatment group receiving the combination of doxorubicin, HER-2 inhibitor, and dapagliflozin. Cardiac function was assessed using echocardiography (VEVO 2100). Biomarkers of myocardial injury and inflammation (NLRP3, MyD88, CXCR4, H-FABP, troponin-T, and cytokines) were quantified via ELISA and immunohistochemistry. Circulating markers such as mitofusin-2, cardiac myosin light chain, malondialdehyde (MDA), and 4-hydroxy-2-nonenal (4-HNE) were also measured. Dapagliflozin significantly preserved the ejection fraction and reduced both radial and longitudinal strain impairment in mice treated with the doxorubicin–HER-2 inhibitor combination (p < 0.001). Levels of myocardial NLRP3, MyD88, CXCR4, H-FABP, interleukin-1β, and troponin-T were significantly lower in the dapagliflozin-treated group compared to the chemotherapy-only group. Serum markers of oxidative stress and cardiac injury, including mitofusin-2, MDA, 4-HNE, BNP, and high-sensitivity C-reactive protein (hs-CRP), were also reduced by dapagliflozin treatment. Our findings demonstrate that dapagliflozin effectively mitigates early cardiac dysfunction and injury in a preclinical model of sequential doxorubicin and HER-2 inhibitor therapy.
Quagliariello et al. (Tue,) conducted a other in Chemotherapy-induced cardiotoxicity. Dapagliflozin vs. Doxorubicin and HER-2-blocking monoclonal antibody was evaluated on Cardiac function (ejection fraction, radial and longitudinal strain) (p=<0.001). Dapagliflozin significantly preserved ejection fraction and reduced radial and longitudinal strain impairment in mice treated with doxorubicin and a HER-2 inhibitor (p < 0.001).