BACKGROUND AND OBJECTIVE: Anthracyclines are well established and highly efficacious antineoplastic agents for various haematopoietic and solid tumours, such as breast cancer. The main adverse effect of anthracycline therapy is cardiotoxicity. The aim of this prospective study was to determine the role of plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing left ventricular function in early breast cancer patients receiving adjuvant anthracycline treatment. METHODS: Thirty-three newly diagnosed breast cancer patients who received a total doxorubicin dosage of 240 mg/m2 over four treatment cycles as part of adjuvant chemotherapy after curative breast surgery were included in this study. Venous NT-proBNP levels were measured before and at the end of doxorubicin therapy. Left ventricular function was measured by echocardiography conducted 3 weeks after surgery and at the end of doxorubicin therapy. RESULTS: NT-proBNP levels were significantly higher in patients (n=10) with decreased left ventricular ejection fraction (LVEF) [p=0.02]. There was no difference in LVEF (p=0.164) or NT-proBNP levels (p=0.844) between the patients who had high NT-proBNP levels and those who had normal NT-proBNP levels before doxorubicin chemotherapy. None of the factors studied (breast cancer grade, estrogen receptor status, progesterone receptor status, human epidermal growth factor receptor 2 status, age) was found to be significantly related to NT-proBNP. CONCLUSION: The association between higher NT-proBNP levels and reduced LVEF in asymptomatic breast cancer patients after doxorubicin administration could be an early indication of subclinical acute anthracycline cardiotoxicity. Furthermore, breast cancer patients experiencing a progressive increase in NT-proBNP levels might be in a higher risk group for acute anthracycline cardiotoxicity.
BACKGROUND AND OBJECTIVE:Anthracyclines are well established and highly efficacious antineoplastic agents for various haematopoietic and solid tumours, such as breast cancer. The main adverse effect of anthracycline therapy is cardiotoxicity. The aim of this prospective study was to determine the role of plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) in assessing left ventricular function in early breast cancerpatients receiving adjuvant anthracycline treatment. METHODS: Thirty-three newly diagnosed breast cancerpatients who received a total doxorubicin dosage of 240 mg/m2 over four treatment cycles as part of adjuvant chemotherapy after curative breast surgery were included in this study. Venous NT-proBNP levels were measured before and at the end of doxorubicin therapy. Left ventricular function was measured by echocardiography conducted 3 weeks after surgery and at the end of doxorubicin therapy. RESULTS:NT-proBNP levels were significantly higher in patients (n=10) with decreased left ventricular ejection fraction (LVEF) [p=0.02]. There was no difference in LVEF (p=0.164) or NT-proBNP levels (p=0.844) between the patients who had high NT-proBNP levels and those who had normal NT-proBNP levels before doxorubicin chemotherapy. None of the factors studied (breast cancer grade, estrogen receptor status, progesterone receptor status, humanepidermal growth factor receptor 2 status, age) was found to be significantly related to NT-proBNP. CONCLUSION: The association between higher NT-proBNP levels and reduced LVEF in asymptomatic breast cancerpatients after doxorubicin administration could be an early indication of subclinical acute anthracycline cardiotoxicity. Furthermore, breast cancerpatients experiencing a progressive increase in NT-proBNP levels might be in a higher risk group for acute anthracycline cardiotoxicity.
Authors: M T Meinardi; D J van Veldhuisen; J A Gietema; W V Dolsma; F Boomsma; M P van den Berg; C Volkers; J Haaksma; E G de Vries; D T Sleijfer; W T van der Graaf Journal: J Clin Oncol Date: 2001-05-15 Impact factor: 44.544
Authors: N B Schiller; P M Shah; M Crawford; A DeMaria; R Devereux; H Feigenbaum; H Gutgesell; N Reichek; D Sahn; I Schnittger Journal: J Am Soc Echocardiogr Date: 1989 Sep-Oct Impact factor: 5.251
Authors: M R Cowie; A D Struthers; D A Wood; A J Coats; S G Thompson; P A Poole-Wilson; G C Sutton Journal: Lancet Date: 1997-11-08 Impact factor: 79.321
Authors: Alessandro Colombo; Maria T Sandri; Michela Salvatici; Carlo M Cipolla; Daniela Cardinale Journal: Curr Treat Options Cardiovasc Med Date: 2014-06
Authors: Sibo Tian; Kim M Hirshfield; Salma K Jabbour; Deborah Toppmeyer; Bruce G Haffty; Atif J Khan; Sharad Goyal Journal: Front Oncol Date: 2014-10-09 Impact factor: 6.244
Authors: Raymundo A Quintana; Jose Banchs; Ridhi Gupta; Heather Y Lin; Sean D Raj; Anthony Conley; Vinod Ravi; Dejka Araujo; Robert S Benjamin; Shreyaskumar Patel; Saroj Vadhan-Raj; Neeta Somaiah Journal: Sarcoma Date: 2017-09-26