Cardiac and noncardiac biomarkers in patients undergoing anthracycline chemotherapy – a prospective analysis

Abstract

Background Biomarkers represent a potential tool to identify individuals at risk for anthracycline-induced cardiotoxicity (AICT) prior to symptom onset or left ventricular dysfunction. Methods This study examined the levels of cardiac and noncardiac biomarkers before, after the last dose of, and 3–6 months after completion of doxorubicin chemotherapy. Cardiac biomarkers included 5th generation high-sensitivity cardiac troponin T (cTnT), N-terminal pro-brain natriuretic peptide, growth/differentiation factor-15 (GDF-15), and soluble suppression of tumorigenesis-2 (sST2). Noncardiac biomarkers included activated caspase-1 (CASP-1), activated caspase-3, C-reactive protein, tumor necrosis factor-α, myeloperoxidase (MPO), galectin-3, and 8-hydroxy-2’-deoxyguanosine. Echocardiographic data (LVEF and LVGLS) were obtained at pre- and post-chemotherapy. Subanalysis examined interval changes in biomarkers among high (cumulative doxorubicin dose ≥ 250 mg/m2) and low exposure groups. Results The cardiac biomarkers cTnT, GDF-15, and sST2 and the noncardiac biomarkers CASP-1 and MPO demonstrated significant changes over time. cTnT and GDF-15 levels increased after anthracycline exposure, while CASP-1 and MPO decreased significantly. Subanalysis by cumulative dose did not demonstrate a larger increase in any biomarker in the high-dose group. Conclusions The results identify biomarkers with significant interval changes in response to anthracycline therapy. Further research is needed to understand the clinical utility of these novel biomarkers.

Growth differentiation factor 15 (GDF15) elevation in children with newly diagnosed cancer

“…While the current study utilized a single measurement at baseline and a single measurement 3 months later, the chronic elevation of GDF15 seen in the cancer cohort compared to the control necessitates further investigation into the temporal relationship of GDF15 elevations to chemotherapy administration and the changes in GDF15 over time (17). It may be that there are acute spikes following chemotherapy administration, as was seen with cisplatin administration in animal models, which we failed to detect given that there were only two time points (17,34).…”

Biomarcadores na Avaliação de Pacientes Submetidos à Quimioterapia com Antraciclinas

“…Recentemente, Dean et al examinaram os níveis de biomarcadores cardíacos e não cardíacos antes, após a última dose e 3–6 meses após o término da quimioterapia com doxorrubicina e identificaram biomarcadores com alterações significativas de intervalo em resposta à terapia com antraciclina. 8 …”

“…Recently, Dean et al examined the levels of cardiac and noncardiac biomarkers before, after the last dose of, and 3–6 months after completion of doxorubicin chemotherapy and identified biomarkers with significant interval changes in response to anthracycline therapy. 8 …”

“…Recently, Dean et al examined the levels of cardiac and noncardiac biomarkers before, after the last dose of, and 3-6 months after completion of doxorubicin chemotherapy and identified biomarkers with significant interval changes in response to anthracycline therapy. 8 In this issue was presented the results of a case-control study that compared the results of different cardiovascular biomarkers that were measured in patients with breast cancer after the last cycle of treatment with doxorubicin and in patients without breast cancer or cardiovascular disease. Some differences in the results were found, but they are not definitive about the use of the biomarkers studies.…”