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Observational Study
. 2020 Dec:54:106-113.
doi: 10.1016/j.breast.2020.09.001. Epub 2020 Sep 11.

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

Isabel Blancas  1 , Francisco J Martín-Pérez  2 , José M Garrido  3 , Fernando Rodríguez-Serrano  4
Affiliations
Observational Study

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

Isabel Blancas et al. Breast. 2020 Dec.

Abstract

Background: 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.

Methods: 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.

Results: 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 < 0.0001) with the development of trastuzumab-induced cardiotoxicity.

Conclusion: 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.

Keywords: Breast cancer; Cardiotoxicity; Early diagnosis; HER2; NT-proBNP; Trastuzumab.

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Conflict of interest statement

Declaration of competing interest The authors have stated that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
ROC curves of plasma NT-proBNP levels for the diagnosis of cardiotoxicity during trastuzumab treatment in breast cancer patients. ROC curves considering all the patients in the study (A) or those patients aged 50–75 years old (B).
See this image and copyright information in PMC

References

    1. Slamon D., Clark G., Wong S., Levin W., Ullrich A., McGuire W. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science. 1987;235:177–182. - PubMed
    1. Pernas S., Barroso-Sousa R., Tolaney S. Optimal treatment of early stage HER2-positive breast cancer. Cancer. 2018;124:4455–4466. - PubMed
    1. Krasniqi E., Barchiesi G., Pizzuti L., Mazzotta M., Venuti A., Maugeri-Saccà M. Immunotherapy in HER2-positive breast cancer: state of the art and future perspectives. J Hematol Oncol. 2019;12:111. - PMC - PubMed
    1. Nemeth B., Varga Z., Wu W., Pacher P. Trastuzumab cardiotoxicity: from clinical trials to experimental studies. Br J Pharmacol. 2017;174:3727–3748. - PMC - PubMed
    1. Viani G., Afonso S., Stefano E., De Fendi L., Soares F. Adjuvant trastuzumab in the treatment of her-2-positive early breast cancer: a meta-analysis of published randomized trials. BMC Canc. 2007;7:153. - PMC - PubMed

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