High-Sensitivity Troponin T and NT-proBNP Kinetics in Breast Cancer Chemotherapy.

Abstract

BACKGROUND/AIMS:

Doxorubicin (DOX) and trastuzumab (TRA) are associated with cardiac dysfunction.

METHOD:

High-sensitivity troponin T (hs-TnT) and brain natriuretic peptide attached to the amino acid N-terminal fragment in the prohormone (NT-proBNP) were measured before and on days +1, +2, +3, and +7 during cycles 1 and 2 of therapy with DOX or TRA in breast cancer patients.

RESULTS:

Five of eleven DOX-treated women, compared with 2/11 TRA-treated women, had undetectable baseline hs-TnT. By day +1 of cycle 2, all the DOX-treated women (p = 0.03) but only 7/11 TRA-treated women (p = ns) had detectible hs-TnT. Time to peak was 1-2 days for both groups. In the DOX-treated women, hs-TnT showed significant peaks from precycle baseline, increases in precycle 1 to precycle 2 levels, and a cycle 1 to cycle 2 peak and area under the curve (AUC). hs-TnT increased from precycle (1, 4.6 ± 6.3 pg/mL) to a cycle 2 peak of 16.1 ± 15.0 pg/mL (p < 0.002). No increases were seen with the TRA treatment. Transient posttreatment increases in NT-proBNP were seen after both therapies.

CONCLUSION:

DOX was associated with increased pretreatment baseline, peak, and AUC hs-TnT levels. Both DOX and TRA acutely perturb NT-proBNP. Assessment of pre- and posttreatment hs-TnT could be a means of quantifying cumulative myocardial injury in the course of chemotherapy.

• Authors: Pooja Advani, Jonathan Hoyne, Alvaro Moreno-Aspita, Marcia Dubin, Shelly Brock, Caroline Harlow, Saranya Chumsri, Thomas Suter, Joseph L Blackshear
• Journal: Chemotherapy (Chemotherapy) Vol. 62 Issue 6 Pg. 334-338 ( 2017) ISSN: 1421-9794 [Electronic] Switzerland
• PMID: 28704807 (Publication Type: Journal Article)
• Copyright: © 2017 S. Karger AG, Basel.

Chemical References

• Antineoplastic Agents
• Peptide Fragments
• Troponin T
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Doxorubicin
• Trastuzumab

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Area Under Curve
• Breast Neoplasms (drug therapy, pathology)
• Doxorubicin (therapeutic use)
• Female
• Humans
• Immunoassay
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Neoplasm Staging
• Peptide Fragments (blood)
• ROC Curve
• Trastuzumab (therapeutic use)
• Troponin T (blood)