Publication:
NT-proBNP as predictor factor of cardiotoxicity during trastuzumab treatment in breast cancer patients.

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Date

2020-09-01

Authors

Blancas, Isabel
Martin-Perez, Francisco J
Garrido, Jose M
Rodriguez-Serrano, Fernando

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Churchill Livingstone
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Abstract

Trastuzumab is a drug used in HER2-positive breast cancer that increases patient survival. Due to cardiotoxicity is the most important side effect of trastuzumab treatment, cardiac monitoring should be a priority. The purpose of this study is to evaluate plasma NT-proBNP level and major cardiovascular risk factors as possible early predictors of trastuzumab-induced cardiotoxicity in HER2-positive breast cancer patients. We conducted a retrospective observational study involving 66 patients with HER2-positive breast cancer treated with trastuzumab. Left ventricle ejection fraction (LVEF), NT-proBNP values, and the history of cardiovascular risk factors were collected. Cardiotoxicity was diagnosed considering a decrease of the LVEF from baseline or clinical manifestation of congestive heart failure. NT-proBNP cut-off points were considered to establish normal or abnormal values according to patient age. 27.3% of the patients suffered cardiotoxicity during trastuzumab treatment. Most cases were diagnosed due to the appearance of cardiac symptomatology (66.7%). Logistic regression analysis showed a significant association of diabetes mellitus (OR 5.9, 95% CI 1.2-28.5, p = 0.028) and high NT-proBNP levels (OR 22.0, 95% CI 5.7-85.4, p  NT-proBNP levels above the upper limit of the normal range adjusted to age or diabetes mellitus seem to be associated with a higher risk of developing cardiotoxicity. However, some limitations of the present study make necessary further studies aimed to clarify whether NT-proBNP and diabetes-associated markers determinations can be useful in the monitoring of cardiotoxicity risk in breast cancer patients undergoing trastuzumab therapy.

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MeSH Terms

Adult
Aged
Antineoplastic Agents
Biomarkers, Pharmacological
Breast Neoplasms
Cardiotoxicity
Diabetes Mellitus
Drug Monitoring
Female
Heart Disease Risk Factors
Heart Failure
Humans
Logistic Models
Middle Aged
Natriuretic Peptide, Brain
Peptide Fragments
Predictive Value of Tests
Receptor, ErbB-2
Retrospective Studies
Stroke Volume
Trastuzumab
Ventricular Function, Left

DeCS Terms

Antineoplásicos
Biomarcadores farmacológicos
Diabetes Mellitus
Cardiotoxicidad
Estudios retrospectivos
Factores de riesgo de enfermedad cardiaca
Fragmentos de péptidos
Función ventricular izquierda
Insuficiencia cardíaca
Monitoreo de drogas
Modelos logísticos
Neoplasias de la mama
Péptido natriurético encefálico
Receptor ErbB-2
Trastuzumab
Valor predictivo de las pruebas
Volumen sistólico

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Keywords

Breast cancer, Cardiotoxicity, Early diagnosis, HER2, NT-proBNP, Trastuzumab

Citation

Blancas I, Martín-Pérez FJ, Garrido JM, Rodríguez-Serrano F. NT-proBNP as predictor factor of cardiotoxicity during trastuzumab treatment in breast cancer patients. Breast. 2020 Dec;54:106-113.