Why the study?
Trastuzumab is effective for HER2-positive breast cancer, but declines in LVEF and increases in inflammatory and cardiac biomarkers can lead to therapy cessation.
Does Coenzyme Q10 prevent trastuzumab-induced cardiotoxicity (LVEF decline and biomarker elevation) in female patients with HER2+ breast cancer?
Does Coenzyme Q10 prevent trastuzumab-induced cardiotoxicity (LVEF decline and biomarker elevation) in female patients with HER2+ breast cancer?
Coenzyme Q10 supplementation may offer a cardioprotective effect against trastuzumab-induced cardiotoxicity by preserving left ventricular ejection fraction and reducing inflammatory and cardiac biomarkers.
May support adjunctive CoQ10 to limit trastuzumab cardiotoxicity; leaves open need for randomized confirmation before practice change.
Trastuzumab is a successful treatment option for HER2-positive breast cancer, but a decline in left ventricular ejection fraction (LVEF) and an increase in inflammatory and cardiac enzyme biomarkers can lead to cessation and termination of therapy. This study aimed to investigate the ability of Coenzyme Q10 (Coq10) to avoid these adverse effects. The study included 100 female patients with HER2+ (HER2+3 or amplified gene) breast cancer. All patients underwent standard adjuvant chemotherapy regimens, which involved a four-cycle treatment of Adriamycin, Cyclophosphamide, Docetaxel, and an initial 8 mg/kg loading dose of trastuzumab, followed by a year of 6 mg/kg maintenance doses every three weeks. One group of 50 patients received trastuzumab and a placebo, while the other 50 were given trastuzumab and CoQ10 for a full year. The CoQ10-treated group exhibited a statistically significant decrease in levels of monocyte chemoattractant protein-1 (MCP-1), interleukin-6 (IL6), soluble toll-like receptor 4 (sTLR4), and cardiac troponin I (cTnI) compared to the control group (p<0.05). However, there was no significant difference in the mean F2-isoprostane levels between the treated and the control groups at any data collection point. Furthermore, the CoQ10-treated group experienced a significant reduction in the decline of EF levels compared to the control group at all stages except for baseline. According to our findings, Coenzyme Q10 protected patients with HER2+3 breast cancer from the cardiotoxicity of trastuzumab by increasing ejection fraction and decreasing inflammatory biomarkers and cardiac enzyme levels.
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Hadi et al. (2023) studied this question.
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