Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial
Background Patients with breast cancer can be affected by cardiotoxic reactions through cancer therapies. Cardiac biomarkers, like NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) and high‐sensitivity cardiac troponin T, might have predictive value. Methods and Results Echocardiography, ECG, he...
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| Format: | Article |
| Language: | English |
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Wiley
2020-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.018143 |
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| author | Alexandra Maria Rüger Andreas Schneeweiss Sabine Seiler Hans Tesch Marion van Mackelenbergh Frederik Marmé Kristina Lübbe Bruno Sinn Thomas Karn Elmar Stickeler Volkmar Müller Christian Schem Carsten Denkert Peter A. Fasching Valentina Nekljudova Tania Garfias‐Macedo Gerd Hasenfuß Wilhelm Haverkamp Sibylle Loibl Stephan von Haehling |
| author_facet | Alexandra Maria Rüger Andreas Schneeweiss Sabine Seiler Hans Tesch Marion van Mackelenbergh Frederik Marmé Kristina Lübbe Bruno Sinn Thomas Karn Elmar Stickeler Volkmar Müller Christian Schem Carsten Denkert Peter A. Fasching Valentina Nekljudova Tania Garfias‐Macedo Gerd Hasenfuß Wilhelm Haverkamp Sibylle Loibl Stephan von Haehling |
| author_sort | Alexandra Maria Rüger |
| collection | DOAJ |
| description | Background Patients with breast cancer can be affected by cardiotoxic reactions through cancer therapies. Cardiac biomarkers, like NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) and high‐sensitivity cardiac troponin T, might have predictive value. Methods and Results Echocardiography, ECG, hemodynamic parameters, NT‐proBNP and high‐sensitivity cardiac troponin T were assessed in 853 patients with early‐stage breast cancer randomized in the German Breast Group GeparOcto‐GBG 84 phase III trial. Patients received neo‐adjuvant dose‐dense, dose‐intensified epirubicin, paclitaxel, and cyclophosphamide (iddEPC group, n=424) or paclitaxel, non‐pegylated doxorubicin, and in triple negative breast cancer, (paclitaxel, non‐pegylated doxorubicin, carboplatin group, n=429) treatment for 18 weeks. Patients positive for human epidermal growth receptor 2 (n=354, 41.5%) received monoclonal antibodies on top of allocated therapy; 119 (12.9%) of all patients showed a cardiotoxic reaction during therapy (15 [1.8%] using a more strict definition). Presence of cardiotoxic reactions was irrespective of treatment allocation (P=0.31). Small but significant increases in NT‐proBNP developed early in patients with a cardiotoxic reaction as compared with those without in whom NT‐proBNP rose only towards the end of therapy (P=0.04). High‐sensitivity cardiac troponin T rose early in both groups. Logistic regression showed that NT‐proBNP (odds ratio [OR], 1.03; 95% CI, 1.008–1.055; P=0.01) and hemoglobin (OR, 1.31; 95% CI, 1.05–1.63; P=0.02) measured at 6 weeks after treatment initiation were significantly associated with cardiotoxic reactions. Conclusions NT‐proBNP and hemoglobin are significantly associated with cardiotoxic reactions in patients with early‐stage breast cancer undergoing dose‐dense and dose‐intensified chemotherapy, but high‐sensitivity cardiac troponin T is not. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT02125344. |
| first_indexed | 2024-04-13T16:35:57Z |
| format | Article |
| id | doaj.art-46c86bc254f44a5c93525d356c2959b8 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:35:57Z |
| publishDate | 2020-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-46c86bc254f44a5c93525d356c2959b82022-12-22T02:39:26ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-12-0192310.1161/JAHA.120.018143Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 TrialAlexandra Maria Rüger0Andreas Schneeweiss1Sabine Seiler2Hans Tesch3Marion van Mackelenbergh4Frederik Marmé5Kristina Lübbe6Bruno Sinn7Thomas Karn8Elmar Stickeler9Volkmar Müller10Christian Schem11Carsten Denkert12Peter A. Fasching13Valentina Nekljudova14Tania Garfias‐Macedo15Gerd Hasenfuß16Wilhelm Haverkamp17Sibylle Loibl18Stephan von Haehling19Department of Cardiology Charité – Universitätsmedizin BerlinBerlin, Campus Virchow‐Klinikum Berlin GermanyNational Center for Tumor Diseases University Hospital and German Cancer Research Center Heidelberg GermanyGerman Breast GroupNeu‐Isenburg and Center for Hematology and Oncology Bethanien Frankfurt GermanyPraxis Bethanien Frankfurt GermanyUniversity Hospital Schleswig‐Holstein Kiel GermanyDepartment of Gynecologic Oncology Medical Faculty Mannheim Heidelberg UniversityUniversity Hospital Mannheim Mannheim GermanyDiakovere Henriettenstift Hannover GermanyCharité Universitätsmedizin Berlin Berlin GermanyGoethe University Hospital Frankfurt Frankfurt GermanyUniversity Hospital RWTH Aachen Aachen GermanyDepartment of Gynecology University Medical Center Hamburg Eppendorf Hamburg GermanyMammazentrum Hamburg Hamburg GermanyUniversity Hospital Marburg Marburg GermanyUniversity Hospital Erlangen Nuremberg GermanyGerman Breast GroupNeu‐Isenburg and Center for Hematology and Oncology Bethanien Frankfurt GermanyDepartment of Cardiology and Pneumology University of Göttingen Medical Center Göttingen GermanyDepartment of Cardiology and Pneumology University of Göttingen Medical Center Göttingen GermanyDepartment of Cardiology Charité – Universitätsmedizin BerlinBerlin, Campus Virchow‐Klinikum Berlin GermanyGerman Breast GroupNeu‐Isenburg and Center for Hematology and Oncology Bethanien Frankfurt GermanyDepartment of Cardiology and Pneumology University of Göttingen Medical Center Göttingen GermanyBackground Patients with breast cancer can be affected by cardiotoxic reactions through cancer therapies. Cardiac biomarkers, like NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) and high‐sensitivity cardiac troponin T, might have predictive value. Methods and Results Echocardiography, ECG, hemodynamic parameters, NT‐proBNP and high‐sensitivity cardiac troponin T were assessed in 853 patients with early‐stage breast cancer randomized in the German Breast Group GeparOcto‐GBG 84 phase III trial. Patients received neo‐adjuvant dose‐dense, dose‐intensified epirubicin, paclitaxel, and cyclophosphamide (iddEPC group, n=424) or paclitaxel, non‐pegylated doxorubicin, and in triple negative breast cancer, (paclitaxel, non‐pegylated doxorubicin, carboplatin group, n=429) treatment for 18 weeks. Patients positive for human epidermal growth receptor 2 (n=354, 41.5%) received monoclonal antibodies on top of allocated therapy; 119 (12.9%) of all patients showed a cardiotoxic reaction during therapy (15 [1.8%] using a more strict definition). Presence of cardiotoxic reactions was irrespective of treatment allocation (P=0.31). Small but significant increases in NT‐proBNP developed early in patients with a cardiotoxic reaction as compared with those without in whom NT‐proBNP rose only towards the end of therapy (P=0.04). High‐sensitivity cardiac troponin T rose early in both groups. Logistic regression showed that NT‐proBNP (odds ratio [OR], 1.03; 95% CI, 1.008–1.055; P=0.01) and hemoglobin (OR, 1.31; 95% CI, 1.05–1.63; P=0.02) measured at 6 weeks after treatment initiation were significantly associated with cardiotoxic reactions. Conclusions NT‐proBNP and hemoglobin are significantly associated with cardiotoxic reactions in patients with early‐stage breast cancer undergoing dose‐dense and dose‐intensified chemotherapy, but high‐sensitivity cardiac troponin T is not. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT02125344.https://www.ahajournals.org/doi/10.1161/JAHA.120.018143biomarkerbreast cancercardio‐oncologycardiotoxicityleft ventricular ejection fraction |
| spellingShingle | Alexandra Maria Rüger Andreas Schneeweiss Sabine Seiler Hans Tesch Marion van Mackelenbergh Frederik Marmé Kristina Lübbe Bruno Sinn Thomas Karn Elmar Stickeler Volkmar Müller Christian Schem Carsten Denkert Peter A. Fasching Valentina Nekljudova Tania Garfias‐Macedo Gerd Hasenfuß Wilhelm Haverkamp Sibylle Loibl Stephan von Haehling Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomarker breast cancer cardio‐oncology cardiotoxicity left ventricular ejection fraction |
| title | Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial |
| title_full | Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial |
| title_fullStr | Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial |
| title_full_unstemmed | Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial |
| title_short | Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOcto‐GBG 84 Trial |
| title_sort | cardiotoxicity and cardiovascular biomarkers in patients with breast cancer data from the geparocto gbg 84 trial |
| topic | biomarker breast cancer cardio‐oncology cardiotoxicity left ventricular ejection fraction |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.018143 |
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