Key result
Sequential chemotherapy in women with HER2-positive breast cancer resulted in clinical cardiotoxicity in 6.3-10.9% of cases, with early manifestations detectable at 3 weeks.
Why the study?
To monitor biomarker dynamics during chemotherapy and targeted therapy in HER2-positive breast cancer, compare early biochemical and echocardiographic criteria, and determine the best timing to assess latent subclinical cardiotoxicity.
Do serum biomarkers and speckle tracking echocardiography detect early chemotherapy-induced cardiotoxicity in women with HER2-positive breast cancer?
Observational (n=229)
Do serum biomarkers and speckle tracking echocardiography detect early chemotherapy-induced cardiotoxicity in women with HER2-positive breast cancer?
Left ventricular global longitudinal strain is a consistent early marker of cardiotoxicity across different chemotherapy regimens in HER2-positive breast cancer, while biomarkers (hs-cTnI, NT-proBNP) are useful primarily during anthracycline and docetaxel/trastuzumab therapy.
LV GLS may aid early cardiotoxicity monitoring across regimens; leaves open incremental biomarker value during trastuzumab monotherapy.
Aim To monitor the dynamics of biomarkers during chemotherapy, targeted chemotherapy and targeted monotherapy in patients with HER2-positive breast cancer (BC); to analyze the emergence timing of these changes; to compare early biochemical and echocardiographic criteria; and to determine the best time for assessing latent subclinical cardiac dysfunction.Material and methods Patients with BC (229 women aged 57±11 years) treated sequentially with anthracyclines, a combination of docetaxel and trastuzumab, and trastuzumab monotherapy were examined during three blocks of BC therapy until the development of clinical cardiotoxicity. Time-related changes in high-sensitivity cardiac troponin I, N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular (LV) global longitudinal strain (GLS) and LV ejection fraction (EF) (up to 12 speckle-tracking echocardiograms/up to 12 laboratory tests) were analyzed. Clinical cardiotoxicity was defined as a symptomatic decrease in LV EF ≥10% from the baseline value of 54% or more.Results Clinically significant cardiotoxicity developed in 6.3-10.9% of cases depending on the treatment option for BC. Early manifestations of cardiotoxicity were detected already at 3 weeks after the start of the first course of chemotherapy. For the BC treatment with anthracyclines and targeted chemotherapy with docetaxel and trastuzumab, the markers of clinical cardiotoxicity were high-sensitivity cardiac troponin I, NT-proBNP and GLS LV. For the trastuzumab monotherapy, only GLS LV had a prognostic value. No statistically significant changes in the concentrations of high-sensitivity troponin I and NT-proBNP were found.Conclusion For timely detection of clinical cardiotoxicity, laboratory tests (high-sensitivity troponin I, NT-proBNP) and echocardiography (GLS LV) are recommended to be performed every 3 weeks before the next course of BC therapy. While doing so, their sensitivity will depend on the treatment option for BC.
No takes yet. Share an insight, caveat, or question.
uulu et al. (2025) conducted an observational in HER2-positive breast cancer (n=229). Sequential chemotherapy (anthracyclines, docetaxel, trastuzumab) was evaluated on Clinical cardiotoxicity (symptomatic decrease in LV EF ≥10% from baseline ≥54%). Sequential chemotherapy in women with HER2-positive breast cancer resulted in clinical cardiotoxicity in 6.3-10.9% of cases, with early manifestations detectable at 3 weeks.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: