Key result
Neoadjuvant FEC-C therapy demonstrates acceptable cardiac safety with decreased NT-proBNP and no clinical damage.
Why the study?
The cardiac safety profile of neoadjuvant FEC-C chemotherapy with concurrent celecoxib in patients with locally advanced breast cancer was not well characterized.
Does neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide with concurrent celecoxib (FEC-C) cause cardiac injury in patients with locally advanced breast cancer?
Cohort
Does neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide with concurrent celecoxib (FEC-C) cause cardiac injury in patients with locally advanced breast cancer?
The neoadjuvant FEC-C regimen demonstrates an acceptable short-term cardiac safety profile in patients with locally advanced breast cancer, as evidenced by stable cardiac biomarkers.
Supports short-term cardiac safety of FEC-C in small cohort without clinical harm; leaves open long-term cardiotoxicity in prospective trials.
PURPOSES: This substudy aimed to examine the changes in biomarkers for cardiac injury in patients who received neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide with concurrent celecoxib (FEC-C). METHODS: ) with concurrent celecoxib (400 mg bid). Blood samples were drawn from patients on day (D) 0, D3, D21, D42, and D63 (end of therapy), and the serum levels of lactate dehydrogenase (LDH) and plasma levels of cardiac troponin I (cTnI) and N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) were measured with commercially available test kits. RESULTS: All patients tolerated this regimen well. Neither life-threatening toxicity nor clinical symptoms of cardiac damage were observed. Serum LDH increased significantly from baseline after 3 cycles of FEC-C (p<0.0001), but the change was possibly brought about by chemotherapy-induced liver derangement. However, NT-proBNP decreased significantly (p=0.009), while cTnI increased nonsignificantly (p=0.078) after 3 cycles of FEC-C compared to baseline, although this increase was still regarded as normal. CONCLUSIONS: Short-term use of the FEC-C regimen has proven to be effective in locally advanced breast cancer, with an acceptable cardiac safety profile.
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Chow et al. (2013) conducted a cohort in Locally advanced breast cancer. Neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide and celecoxib (FEC-C) vs. Baseline was evaluated on Changes in biomarkers for cardiac injury (LDH, cTnI, NT-proBNP). Neoadjuvant FEC-C therapy for breast cancer demonstrated an acceptable cardiac safety profile, with a significant decrease in NT-proBNP (p=0.009) and no clinical symptoms of cardiac damage.
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