Evaluation of biomarkers for cardiotoxicity of anthracyclin-based chemotherapy
- F. J. F. BroeyerAffiliated withCentre for Human Drug Research Email author
- , S. OsantoAffiliated withLeiden University Medical Center
- , H. J. Ritsema van EckAffiliated withAdvanced Medical Systems
- , A. Q. M. J. van SteijnAffiliated withLeiden University Medical Center
- , B. E. P. B. BallieuxAffiliated withLeiden University Medical Center
- , R. C. SchoemakerAffiliated withCentre for Human Drug Research
- , A. F. CohenAffiliated withCentre for Human Drug Research
- , J. BurggraafAffiliated withCentre for Human Drug Research
The clinical assessment of the myocardial damage caused by anthracyclin (ANT)-therapy is difficult. Therefore a study was performed to evaluate non-invasive markers of anthracyclin-induced cardiac effects, with emphasis on course-to-course variation.
Eligible for study participation were patients, without known cardiologic abnormalities who did not use cardiotoxic medication (except for ANT-therapy), who had previously completed at least three cycles of anthracyclin-containing chemotherapy (n = 14) and patients who were ANT-naïve and who were scheduled to receive doxorubicin-containing chemotherapy (n = 12). Seven patients in this last group also completed at least three cycles and were available for follow-up assessments; thus a total population of 21 patients (12F/9M) completed at least three courses ANT-chemotherapy. In these patients blood samples and ECG-recordings were taken within 6 months after completion of ANT-therapy. In 12 patients (10F/2M) assessments were also done before, immediately afterwards and at 24 h after each course of ANT.
Results and Conclusions
In the patients who completed chemotherapy, NT-proBNP was 277% (n = 21; 95% CI: 86–661%, P < 0.001) higher compared to healthy volunteers. During the first course NT-proBNP rose 269% (n = 12; 167–409%, P < 0.0001) at 24 h post-administration. The linear corrected QT (QTcL) directly after the first administration of ANT increased by 9.56 ms (n = 12; 3.85–15.27, P < 0.001) and this prolongation was still present at 24 h, 11.48 ms (n = 12; 5.61–17.34, P < 0.0001). Both NT-proBNP and QTcL returned to baseline before the start of the next course and a similar pattern was observed during each course. NT-proBNP and QTcL may be useful markers for course-to-course evaluation of anthracyclin-induced cardiotoxicity.
KeywordsAnthracyclines Cardiotoxicity Biomarkers Electrocardiography
- Evaluation of biomarkers for cardiotoxicity of anthracyclin-based chemotherapy
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of Cancer Research and Clinical Oncology
Volume 134, Issue 9 , pp 961-968
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- 1. Centre for Human Drug Research, Zernikedreef 10, 2333 CL, Leiden, The Netherlands
- 2. Leiden University Medical Center, Leiden, The Netherlands
- 3. Advanced Medical Systems, Maasdam, The Netherlands