Let-7f and miRNA-126 correlate with reduced cardiotoxicity risk in triple-negative breast cancer patients who underwent neoadjuvant chemotherapy.

This study aimed to explore the correlation of circulating angiogenic microRNAs (miRNAs) with the occurrence of cardiotoxicity in triple-negative breast cancer (TNBC) patients who underwent epirubicin/cyclophosphamide-docetaxel (EC-D) neoadjuvant chemotherapy. One hundred seventy-nine TNBC patients were consecutively enrolled and received EC-D neoadjuvant chemotherapy. Plasma samples were collected before neoadjuvant treatment, and relative expression of angiogenic miRNAs was measured by real-time quantitative polymerase chain reaction. Cardiotoxicity was defined by any one of the following symptoms: heart failure, acute coronary artery syndrome, fatal arrhythmia and a left ventricular ejection fraction (LVEF) declined by 10% from baseline to an absolute value below 53%. The LVEF level was decreased, while cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were increased by EC-D neoadjuvant chemotherapy. In total, 9 cases (5.0%) of cardiotoxicity occurred. Let-7f, miR-126 and miR-210 were negatively associated with the cTnI level, while let-7f, miR-19a and miR-130a were negatively correlated with the NT-proBNP level. Compared to noncardiotoxicity patients, the expression levels of let-7f, miR-19a, miR-20a, miR-126, and miR-210 were decreased in cardiotoxicity patients. A multivariate logistic regression analysis revealed that let-7f and miR-126 independently predicted low cardiotoxicity risk, and a receiver operating characteristics curve illustrated that let-7f (area under curve [AUC]=0.815, 95% CI: 0.725-0.906) and miR-126 (AUC=0.731, 95% CI: 0.624-0.838) as well as the combination of these two miRNAs (AUC=0.885, 95% CI: 0.818-0.952) could effectively distinguish cardiotoxicity patients from noncardiotoxicity patients. The angiogenic miRNAs let-7f and miR-126 might serve as novel and convincing biomarkers for reduced cardiotoxicity risk in TNBC patients who receive EC-D neoadjuvant chemotherapy. IJCEP