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Prediction of Anthracycline Cardiotoxicity after Chemotherapy by Biomarkers Kinetic Analysis

Content Provider	Springer Nature Link
Author	Garrone, Ornella Crosetto, Nicola Lo Nigro, Cristiana Catzeddu, Tiziana Vivenza, Daniela Monteverde, Marti Merla, Marco Feola, Mauro
Copyright Year	2011
Abstract	Anthracyclines are active drugs against breast cancer, but can exert cardiotoxic effects. We analyzed the association between the kinetics of various biomarkers during chemotherapy, and the risk of subsequent cardiac toxicity. 50 patients (49 women) with early breast cancer surgically treated and eligible to anthracycline-based adjuvant chemotherapy were analyzed. The left ventricular ejection fraction (LVEF) together with the plasma concentration of several blood markers was measured at the beginning of anthracycline chemotherapy (t $_{0}$), 5 months (t $_{1}$), 16 months (t $_{2}$), 28 months (t $_{3}$), and 40 months later (t $_{4}$). A single measured LVEF value less than 50% or a clinically overt congestive heart failure (CHF) was considered cardiotoxic effects. We tested whether the kinetics of LVEF and blood biomarkers measured during chemotherapy was predictive of subsequent cardiotoxicity and overall cardiac fitness. The left ventricular ejection fraction measured at the end of treatment as well as the rate of change of hemoglobin concentration during anthracycline-based chemotherapy predicted cardiotoxicity in a 3-year follow-up period. When LVEF at the end of chemotherapy was lower than 53% or hemoglobin blood concentration declined more than 0.33 g/dL/month during chemotherapy, the odds ratio of subsequent cardiotoxicity was 37.3 and 18, respectively. The specificity of these two tests was 93.3% and 80%, whereas the sensitivity was 90.9 and 81.2%, respectively. Testing the rate of change of hemoglobin concentration during anthracycline-based chemotherapy, as well as the left ventricular ejection fraction at the end of treatment, seems a powerful method to assess the effects of anthracyclines on cardiac fitness and identify patients at high risk of CHF. Further validation of these tests on a large cohort of patients and cost-benefit analysis should be encouraged.
Starting Page	135
Ending Page	142
Page Count	8
File Format	PDF
ISSN	15307905
Journal	Cardiovascular Toxicology
Volume Number	12
Issue Number	2
e-ISSN	15590259
Language	English
Publisher	Humana Press Inc
Publisher Date	2011-12-22
Publisher Place	New York
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Anthracycline cardiotoxicity Breast cancer Biomarkers Cardiology Pharmacology/Toxicology
Content Type	Text
Resource Type	Article
Subject	Molecular Biology Toxicology Cardiology and Cardiovascular Medicine

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