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Current methods to identify patients at risk for cancer therapy cardiotoxicity are inadequate.
All consecutive women with HER2-positive breast cancer and scheduled to receive adjuvant chemotherapy including anthracyclines, taxanes and trastuzumab. The biomarkers assessed in this study were high-sensitivity troponin I(hs-TnI) and thymosin β4 (Tβ4). Blood samples were obtained at baseline, three and six months.
At all time points, patients with elevated changes in both biomarkers had the greatest risk of cardiotoxicity. Interval changes in Tβ4 and TnI provided additive value in predicting subsequent cardiotoxicity, with a HR=14.22 and HR 13.38 of (95%CI 3.32 to 60.95, p<0.01) and (95%CI 9.11 to 96.52, p=0.04).
Early increases in TnI and Tβ4 offer additive information about cardiotoxicity risk in patients undergoing doxorubicin and trastuzumab therapy. Our findings suggest that the combination of Tβ4 and TnI could improve the detection of trastuzumab-induced cardiotoxicity.