An hs-TnT level cutoff of 5.5 pg/mL at 6 months predicted a reduction of LVEF at 15 months with 78% sensitivity and 80% specificity in breast cancer patients receiving adjuvant trastuzumab.
Cohort (n=19)
Single-blind
No
Does high-sensitivity troponin T predict trastuzumab-induced cardiotoxicity in women with HER2-positive breast cancer receiving adjuvant chemotherapy?
Elevated high-sensitivity troponin T at 6 months and impaired baseline diastolic function can predict subsequent trastuzumab-induced cardiotoxicity in breast cancer patients.
Absolute Event Rate: 11% vs 4%
p-value: p=<0.01
The humanized monoclonal antibody trastuzumab has been in routine use for chemotherapy for human epidermal growth factor receptor II (HER2)-positive breast cancer. A major adverse effect of trastuzumab is cardiotoxicity. Well-established biomarkers or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity have not yet been determined. We attempted to identify useful biomarkers and/or echocardiographic parameters to predict trastuzumab-induced cardiotoxicity. We prospectively investigated the cases of 19 women who received chemotherapy including anthracyclines and trastuzumab for HER2-positive breast cancer. We measured cardiac biomarkers and echocardiographic parameters before their chemotherapy and every 3 months up to 15 months until the end of the adjuvant trastuzumab therapy. We divided the patients into two groups: group R was the nine patients who showed a reduction of left ventricular ejection fraction (LVEF) ≥5%, and group N was the 10 patients who showed a reduction of LVEF <5%. The high-sensitivity troponin T (hs-TnT) level at 6 months was significantly higher in group R than in group N (11.0 ± 7.8 pg/mL vs. 4.0 ± 1.4 pg/mL, p < 0.01). The hs-TnT level with a cutoff value of 5.5 pg/mL at 6 months had 78% sensitivity and 80% specificity for predicting a reduction of LVEF at 15 months. In our evaluation of echocardiographic parameters at baseline, the diastolic function was more impaired in group R than in group N. The hs-TnT and echocardiographic parameters of diastolic function could be useful to predict trastuzumab-induced cardiotoxicity.
Katsurada et al. (Mon,) conducted a cohort in HER2-positive breast cancer (n=19). Reduction of LVEF ≥5% (Group R) vs. Reduction of LVEF <5% (Group N) was evaluated on hs-TnT level at 6 months (pg/mL) (p=<0.01). An hs-TnT level cutoff of 5.5 pg/mL at 6 months predicted a reduction of LVEF at 15 months with 78% sensitivity and 80% specificity in breast cancer patients receiving adjuvant trastuzumab.