Key result
Prior anthracycline exposure is linked to ~20% higher NT-proBNP levels in breast cancer survivors.
Why the study?
NT-proBNP, sST2, and galectin-3 have been proposed to identify asymptomatic cardiac dysfunction after anthracycline chemotherapy, but comparison of their levels by prior anthracycline receipt in breast cancer survivors required evaluation.
Does prior anthracycline-based chemotherapy increase serum levels of NT-proBNP, sST2, and galectin-3 in breast cancer survivors?
Cohort (n=1,160)
No
Does prior anthracycline-based chemotherapy increase serum levels of NT-proBNP, sST2, and galectin-3 in breast cancer survivors?
Elevated NT-proBNP, but not sST2 or galectin-3, may serve as a useful biomarker of asymptomatic cardiovascular toxicity in breast cancer survivors previously treated with anthracycline-based chemotherapy.
Supports NT-proBNP monitoring for subclinical cardiotoxicity in survivors; leaves open its role in risk stratification or outcomes.
NT-proBNP, soluble ST2 (sST2), and galectin-3 are biomarkers of cardiac dysfunction that have been proposed as identifiers of patients experiencing asymptomatic cardiac dysfunction after anthracycline-based chemotherapy. This study aimed to compare the proportion of breast cancer (BC) survivors with elevated serum levels of these three putative biomarkers by prior receipt of anthracycline (yes vs. no). Five-hundred-eighty survivors of BC who had received anthracycline-based chemotherapy were matched by age and time between diagnosis and serum storage to 580 who had not. Cardiac biomarker levels were analyzed using immunoassays. Analyses were carried out using linear and logistic regression models. Anthracycline recipients had higher values of NT-proBNP than non-recipients (mean 116.0 ng/L vs. 97.0 ng/L, respectively; p < 0.001). Values for ST2 and galectin-3 did not significantly differ by receipt of anthracycline. After further adjustment for age at breast cancer diagnosis, ethnicity, and receipt of trastuzumab, associations between receipt of anthracycline and higher NT-proBNP persisted (p < 0.001), showing that NT-proBNP may be a biomarker of cardiovascular toxicity after receipt of anthracycline-based chemotherapy. Further research to assess the clinical utility of NT-proBNP testing after receipt of anthracycline is recommended. sST2 and galectin-3 do not appear to differentiate between anthracycline recipients and non-recipients amongst breast cancer survivors.
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Patel et al. (2021) conducted a cohort in Breast cancer (n=1,160). Anthracycline-based chemotherapy vs. No prior receipt of anthracycline-based chemotherapy was evaluated on Mean serum NT-proBNP level (ng/L) (p=<0.001). Breast cancer survivors with prior anthracycline exposure had significantly higher mean serum NT-proBNP levels compared to matched non-recipients (116.0 ng/L vs 97.0 ng/L, p < 0.001), suggesting subclinical myocardial injury.
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