Author: Rüger, Alexandra Maria; Schneeweiss, Andreas; Seiler, Sabine; Tesch, Hans; van Mackelenbergh, Marion; Marmé, Frederik; Lübbe, Kristina; Sinn, Bruno; Karn, Thomas; Stickeler, Elmar; Müller, Volkmar; Schem, Christian; Denkert, Carsten; Fasching, Peter A.; Nekljudova, Valentina; Garfiasâ€Macedo, Tania; Hasenfuß, Gerd; Haverkamp, Wilhelm; Loibl, Sibylle; von Haehling, Stephan
Title: Cardiotoxicity and Cardiovascular Biomarkers in Patients With Breast Cancer: Data From the GeparOctoâ€GBG 84 Trial Cord-id: d1rgycq1 Document date: 2020_11_16
ID: d1rgycq1
Snippet: BACKGROUND: Patients with breast cancer can be affected by cardiotoxic reactions through cancer therapies. Cardiac biomarkers, like NTâ€proBNP (Nâ€terminal proâ€Bâ€type natriuretic peptide) and highâ€sensitivity cardiac troponin T, might have predictive value. METHODS AND RESULTS: Echocardiography, ECG, hemodynamic parameters, NTâ€proBNP and highâ€sensitivity cardiac troponin T were assessed in 853 patients with earlyâ€stage breast cancer randomized in the German Breast Group GeparOctoâ€
Document: BACKGROUND: Patients with breast cancer can be affected by cardiotoxic reactions through cancer therapies. Cardiac biomarkers, like NTâ€proBNP (Nâ€terminal proâ€Bâ€type natriuretic peptide) and highâ€sensitivity cardiac troponin T, might have predictive value. METHODS AND RESULTS: Echocardiography, ECG, hemodynamic parameters, NTâ€proBNP and highâ€sensitivity cardiac troponin T were assessed in 853 patients with earlyâ€stage breast cancer randomized in the German Breast Group GeparOctoâ€GBG 84 phase III trial. Patients received neoâ€adjuvant doseâ€dense, doseâ€intensified epirubicin, paclitaxel, and cyclophosphamide (iddEPC group, n=424) or paclitaxel, nonâ€pegylated doxorubicin, and in triple negative breast cancer, (paclitaxel, nonâ€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 NTâ€proBNP developed early in patients with a cardiotoxic reaction as compared with those without in whom NTâ€proBNP rose only towards the end of therapy (P=0.04). Highâ€sensitivity cardiac troponin T rose early in both groups. Logistic regression showed that NTâ€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: NTâ€proBNP and hemoglobin are significantly associated with cardiotoxic reactions in patients with earlyâ€stage breast cancer undergoing doseâ€dense and doseâ€intensified chemotherapy, but highâ€sensitivity cardiac troponin T is not. REGISTRATION: URL: http://www.clinicaltrials.gov; Unique identifier: NCT02125344.
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