Why the study?
Anti-cancer therapies including chemotherapy, biological therapy, and immunotherapy are associated with cardiotoxicity, prompting evaluation of whether cardiac biomarkers can predict cardiotoxicity in patients receiving anthracycline or trastuzumab.
Do acute changes in cardiac biomarkers predict cardiotoxicity (LVEF reduction) in early breast cancer patients receiving anthracycline or trastuzumab?
Do acute changes in cardiac biomarkers predict cardiotoxicity (LVEF reduction) in early breast cancer patients receiving anthracycline or trastuzumab?
In a small observational cohort of breast cancer patients, acute changes in cardiac biomarkers (Troponin, CK-MB) did not correlate with anthracycline- or trastuzumab-induced reductions in left ventricular ejection fraction.
Cardiac biomarkers may aid early risk detection in anthracycline/trastuzumab therapy; leaves open need for prospective validation before practice change.
Aim: To determine if using cardiac biomarker will predict cardiotoxicity in patients with breast cancer receiving cardiotoxic anti-cancer therapy. Chemotherapy, biological therapy and immunotherapy are associated with this type of toxicity. In our study we focused on the use of anthracycline and trastuzumab. Methods: We conducted an observational study in which we followed patients who received cardiotoxic medication and assessed cardiac biomarker before therapy, 48-72 hours after and before next cycle. A mixed effect linear regression model was used with patient as a random intercept to model the clinical endpoints before and after the chemotherapy while controlling important demographics Results: 30 patients with early breast cancer who are receiving treatment at King Abdulaziz University Hospital were eligible. Two patients developed drop in left ventricular ejection fraction. No patient developed symptoms of congestive heart failure. There was no correlation between the elevation in cardiac markers and the decrease in the ejection fraction. Conclusion: In a small observational study on breast cancer patients at KAUH, there was no correlation between cardiac markers changes and reduction in the left ventricular ejection fraction. A larger cohort will be of benefit to prove if there is a significant correlation.
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Shadi Alkhayyat (2022) studied this question.
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