Key result
Trastuzumab-induced cardiotoxicity occurs in ~10% of HER2+ breast cancer patients, linked to diabetes and higher BMI.
Why the study?
Identification of patients at increased risk of trastuzumab-related cardiotoxicity is needed to enable prevention, early diagnosis, and optimal chemotherapy management.
Does NT-proBNP measurement predict trastuzumab-induced cardiotoxicity in women with HER2+ breast cancer?
Cohort (n=52)
Does NT-proBNP measurement predict trastuzumab-induced cardiotoxicity in women with HER2+ breast cancer?
NT-proBNP measurement may provide an additional tool for identifying patients at high risk of trastuzumab-induced cardiotoxicity, particularly those with baseline risk factors such as obesity and diabetes.
May aid early cardiotoxicity risk stratification during trastuzumab; leaves open need for prospective validation before clinical adoption.
Aim: Identification of patient with increased risk of cardiotoxicity would allow not only prevention and early diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. Materials and methods: Fiftytwo women with HER2+ breast cancer treated with trastuzumab were included in this study. Patients were prospectively followed with routine cardiac evaluation. Before and after administration of trastuzumab blood samples for NT-proBNP were also taken. Results: The median age was 48.5 year (range: 26–74). Hypertension and obesity were two most common co-morbidities. The median duration application of trastuzumab was 52 weeks. During median 14.5 (3–33) months follow-up cardiac adverse events occurred in 5 (9.6%) patients and 2 out of 5 was grade III–IV heart failure. Both patients had preserved left ventricular ejection fraction and no symptom of heart failure before trastuzumab but older than 65 years old and had diabetes mellitus and obesity. High level of NT-proBNP (> 300 ng/ml) was observed in both patients and heart failure recovery was not observed. There was statistically significant difference regarding body mass index (p = 0.004) and diabetes mellitus (p = 0.002) between patients with and without cardiotoxicity. Conclusion: Although, cardiac biomarkers still cannot replace routine cardiac monitoring, natriuretic peptides may provide additional tool for detection of patients with high risk of cardiotoxicity and early detection of cardiotoxicity.
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Urun et al. (2015) conducted a cohort in HER2+ breast cancer (n=52). Trastuzumab therapy was evaluated on Cardiac adverse events. In women with HER2+ breast cancer treated with trastuzumab, cardiac adverse events occurred in 9.6% of patients, with cardiotoxicity significantly associated with higher BMI (p=0.004) and diabetes (p=0.002).
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