BACKGROUND: Chemotherapy with anthracyclines is associated with life-threatening electrocardiographic alterations including corrected QT (QTc) interval prolongation. PATIENTS AND METHODS: In this study we assessed the effect of epirubicin, cyclophosphamide, and docetaxel (EC-Doc) on the QTc interval in 10 patients with early breast cancer. Cardiac toxicity was assessed with symptoms, transthoracic echocardiography, electrocardiography (ECG), and serum cardiac markers at baseline and after 4 cycles of EC and 4 cycles of docetaxel. To evaluate the influence of interobserver variation, the QTc interval was analyzed by a cardiologist, a gynecologist, and with automated ECG interpretation software. RESULTS: There was a significant QTc prolongation after EC treatment independent of the investigator. In addition, a significant increase in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels was noted after EC treatment. QTc prolongation and NT-proBNP levels normalized after docetaxel treatment. Other biochemical markers were within normal ranges. No clinically relevant effect on left ventricular ejection fraction was observed. CONCLUSION: This prospective study demonstrated that EC treatment increases the QTc interval and NT-proBNP levels in women with early breast cancer. This effect was reversible and independent of docetaxel administration. Moreover, the treating physician can safely perform QTc interval evaluation as part of clinical routine independent of his/her specialty. Due to the small number of patients, further conclusions are limited at this point.
BACKGROUND: Chemotherapy with anthracyclines is associated with life-threatening electrocardiographic alterations including corrected QT (QTc) interval prolongation. PATIENTS AND METHODS: In this study we assessed the effect of epirubicin, cyclophosphamide, and docetaxel (EC-Doc) on the QTc interval in 10 patients with early breast cancer. Cardiac toxicity was assessed with symptoms, transthoracic echocardiography, electrocardiography (ECG), and serum cardiac markers at baseline and after 4 cycles of EC and 4 cycles of docetaxel. To evaluate the influence of interobserver variation, the QTc interval was analyzed by a cardiologist, a gynecologist, and with automated ECG interpretation software. RESULTS: There was a significant QTc prolongation after EC treatment independent of the investigator. In addition, a significant increase in N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels was noted after EC treatment. QTc prolongation and NT-proBNP levels normalized after docetaxel treatment. Other biochemical markers were within normal ranges. No clinically relevant effect on left ventricular ejection fraction was observed. CONCLUSION: This prospective study demonstrated that EC treatment increases the QTc interval and NT-proBNP levels in women with early breast cancer. This effect was reversible and independent of docetaxel administration. Moreover, the treating physician can safely perform QTc interval evaluation as part of clinical routine independent of his/her specialty. Due to the small number of patients, further conclusions are limited at this point.
Entities:
Keywords:
Anthracyclines; Breast cancer; Cardiotoxicity; Chemotherapy; Epirubicin; QT prolongation
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: Borje Darpo; Marilyn Agin; David J Kazierad; Gary Layton; Gary Muirhead; Peter Gray; Diane K Jorkasky Journal: J Clin Pharmacol Date: 2006-06 Impact factor: 3.126
Authors: Renske Altena; Patrick J Perik; Dirk J van Veldhuisen; Elisabeth Ge de Vries; Jourik A Gietema Journal: Lancet Oncol Date: 2009-04 Impact factor: 41.316
Authors: Frederik J F Broeyer; Susanne Osanto; Jun Suzuki; Felix de Jongh; Henk van Slooten; Bea C Tanis; Tobias Bruning; Jeroen J Bax; Henk J Ritsema van Eck; Marieke L de Kam; Adam F Cohen; Yutaka Mituzhima; Jacobus Burggraaf Journal: Br J Clin Pharmacol Date: 2014-11 Impact factor: 4.335
Authors: Patrick G Morris; Carol Chen; Richard Steingart; Martin Fleisher; Nancy Lin; Beverly Moy; Steven Come; Steven Sugarman; Alyson Abbruzzi; Robert Lehman; Sujata Patil; Maura Dickler; Heather L McArthur; Eric Winer; Larry Norton; Clifford A Hudis; Chau T Dang Journal: Clin Cancer Res Date: 2011-03-03 Impact factor: 12.531
Authors: K Kitagawa; K Kawada; S Morita; M Inada; A Mitsuma; M Sawaki; S Iino; Y Inden; T Murohara; T Imai; Y Ando Journal: Ann Oncol Date: 2011-06-20 Impact factor: 32.976
Authors: Na Xu; Charles H Redfern; Michael Gordon; Stephen Eppler; Bert L Lum; Caroline Trudeau Journal: Cancer Chemother Pharmacol Date: 2014-10-26 Impact factor: 3.333