Creating a Biomarker Panel for Early Detection of Chemotherapy Related Cardiac Dysfunction in Breast Cancer Patients

Abstract

Cardiotoxicity is an important issue for breast cancer patients receiving anthracycline-trastuzumab therapy in the adjuvant setting. Studies show that 3–36% of patients receiving anthracyclines and/or trastuzumab experience chemotherapy related cardiac dysfunction (CRCD) and approximately 17% of patients must stop chemotherapy due to the consequences of CRCD. There is currently no standardized, clinically verified way to detect CRCD early, but common practices include serial echocardiography and troponin measurements, which can be timely, costly, and not always available in areas where health care resources are scarce. Furthermore, detection of CRCD, before there is any echocardiographic evidence of dysfunction or clinical symptoms present, would allow maximal benefit of chemotherapy and minimize cardiac complications. Creating a panel of serum biomarkers would allow for more specificity and sensitivity in the early detection of CRCD, which would be easy to implement and cost effective in places with limited health care. Based on a review of the literature, we propose creating a biomarker panel consisting of topoisomerase 2β, serum troponin T/I, myeloperoxidase, NT-proBNP, miR-208b, miR-34a, and miR-150 in breast cancer patients receiving anthracyclines and/or trastuzumab to detect CRCD before any signs of overt cardiotoxicity are apparent.

Developing a panel of biomarkers and miRNA in patients with myocardial infarction for early intervention strategies of heart failure in West Virginian population

“…These factors are considered instrumental in advocating the deleterious effects on the heart, further weakening its overall function and attributing atherosclerotic effects. Important MI marker, Troponin I, an inhibitory protein present in the myocardium, is a crucial diagnostic marker for MI, which regulates the muscle function of the heart [ 26 ]. The slightest elevation of this protein level from the normal range indicates an ischemic damage making this as one of the important characteristic of the onset of MI [ 26 ].…”

“…Important MI marker, Troponin I, an inhibitory protein present in the myocardium, is a crucial diagnostic marker for MI, which regulates the muscle function of the heart [ 26 ]. The slightest elevation of this protein level from the normal range indicates an ischemic damage making this as one of the important characteristic of the onset of MI [ 26 ]. These characteristics are summarized in Table 1 , and are crucial diagnostic markers that may be monitored post-MI in order to attenuate progression to HF.…”

Prevention and Monitoring of Cardiovascular Complications in Patients With Luminal Her2-Negative Metastatic Breast Cancer

“…Наи-более изучено исследование уровня высокочувстви-тельного тропонина I. Проводятся исследования по поиску таких новых биомаркеров, как топоизоме-раза 2β, миелопероксидаза, N-концевой пропептид натрийуретического гормона (NT-proBNP), микро-рибоксинуклеиновые кислоты (miR-208b, miR-34a, miR-150) [25]. Вместе с этим до сих пор остаются не-решенными вопросы о сроках лабораторного обследо-вания после проведения системного противоопухоле-вого лечения, референтных значениях, использовании тех или иных биомаркеров и дальнейшей тактике [26,27].…”

Diagnosis and Prevention of Cardiotoxicity in Patients With Breast Cancer From the Standpoint of an Oncologist and a Cardiologist

“…Наиболее изучено исследование уровня высокочувствительного тропонина I. Проводятся ис-следования по поиску таких новых биомаркеров, как топоизомераза 2β, миелопероксидаза, N-концевой пропептид натрийуретического гормона (NTproBNP), микрорибоксинуклеиновые кислоты (miR208b, miR-34a, miR-150) [19]. Вместе с тем до сих пор остаются нерешенными вопросы о сроках лаборатор-ного обследования после проведения системного про-тивоопухолевого лечения, референтных значениях использования тех или иных биомаркеров и дальней-шей тактики [20,21].…”