Troponin I and B-type Natriuretic Peptide (BNP) as biomarkers for the prediction of cardiotoxicity in patients with breast cancer treated with adjuvant anthracyclines and trastuzumab

• Published in: Clinica terapeutica Vol. 166; no. 1; p. e67
• Main Authors: Pistillucci, G, Ciorra, A A, Sciacca, V, Raponi, M, Rossi, R, Veltri, E
• Format: Journal Article
• Language: Italian
• Published: Italy 2015
• Subjects: Adjuvants, Immunologic - therapeutic use; Anthracyclines - adverse effects; Anthracyclines - therapeutic use; Antineoplastic Agents - therapeutic use; Biomarkers; Breast Neoplasms - drug therapy; Cardiotoxicity - blood; Early Detection of Cancer; Female; Humans; Natriuretic Peptide, Brain - blood; Risk Assessment; Trastuzumab - adverse effects; Troponin I - blood; NTproBNP; Troponin; Cardiotoxicity; BNP; Trastuzumab
• ISSN: 1972-6007
• DOI: 10.7417/CT.2015.1812

Adjuvant trastuzumab with chemotherapy is the treatment of choice for patients with human epidermal growth factor receptor positive (HER2+) breast cancer and improves the outcome of patients with early breast cancer. However, it is potentially cardiotoxic and there are no validated methods of early detection of cardiotoxicity from trastuzumab following anthracycline-based chemotherapy. Currently, changes in left ventricular ejection fraction (LVEF) are assessed but this approach has limited sensitivity and specificity. Early identification of patients at risk for cardiotoxic effects is a primary goal for both cardiologists and oncologists. Plasma markers such as b-type natriuretic peptide (BNP - an index of elevated filling pressure) and troponin I (TnI - an index of cardiomyocyte damage) may be used to identify the risk of developing cardiac dysfunction during treatment. In this review, we discuss if TnI and/or BNP could be used to help the prevention or treatment of cardiac dysfunction at the earliest possible time.