Abstract

With the gradual prolongation of the overall survival of cancer patients, the cardiovascular toxicity associated with oncology drug therapy and radiotherapy has attracted increasing attention. At present, the main methods to identify early cancer treatment-related cardiac dysfunction (CTRCD) include imaging examination and blood biomarkers. In this review, we will summarize the research progress of subclinical CTRCD-related blood biomarkers in detail. At present, common tumor therapies that cause CTRCD include: (1) Chemotherapy—The CTRCD induced by chemotherapy drugs represented by anthracycline showed a dose-dependent characteristic and most of the myocardial damage is irreversible. (2) Targeted therapy—Cardiovascular injury caused by molecular-targeted therapy drugs such as trastuzumab can be partially or completely alleviated via timely intervention. (3) Immunotherapy—Patients developed severe left ventricular dysfunction who received immune checkpoint inhibitors have been reported. (4) Radiotherapy—CTRCD induced by radiotherapy has been shown to be significantly associated with cardiac radiation dose and radiation volume. Numerous reports have shown that elevated troponin and B-type natriuretic peptide after cancer treatment are significantly associated with heart failure and asymptomatic left ventricular dysfunction. In recent years, a few emerging subclinical CTRCD potential biomarkers have attracted attention. C-reactive protein and ST2 have been shown to be associated with CTRCD after chemotherapy and radiation. Galectin-3, myeloperoxidas, placental growth factor, growth differentiation factor 15 and microRNAs have potential value in predicting CTRCD. In this review, we will summarize CTRCD caused by various tumor therapies from the perspective of cardio-oncology, and focus on the latest research progress of subclinical CTRCD biomarkers.

Highlights

  • Improved early detection methods and the introduction of innovative cancer treatments have allowed a larger number of cancer patients to live longer

  • Serum concentrations of GDF15 were found to increase continuously during the 15-month follow-up of breast cancer patients treated with doxorubicin and trastuzumab, and increased Growth differential factor 15 (GDF-15) levels were significantly associated with an increased risk of left-ventricular ejection fraction (LVEF) reduction [59]

  • Elevated levels of miRNAs, represented by miR-574, suggest an increased risk of radiation-associated cardiotoxicity The expression of miR-29a and miR-150 decreased with the increase of radiation dose A significant increase in GPBB levels after chemotherapy continued until 6 months after chemotherapy and the increased GPBB was significantly associated with left ventricular diastolic dysfunction Changes in serum levels of arginine-nitric Oxide Metabolites were associated with an increased risk of cancer treatment-related cardiac dysfunction (CTRCD) at up to 5.4 years of follow-up

Read more

Summary

INTRODUCTION

Improved early detection methods and the introduction of innovative cancer treatments have allowed a larger number of cancer patients to live longer. Biomarkers for Detecting Early CTRCD can affect longevity, and cancer treatment-related cardiovascular injuries are of particular interest. Chemotherapy, molecular targeted therapy, immunotherapy and radiotherapy can all cause CTRCD Chemotherapeutic agents such as anthracycline induce CTRCD with dosedependent ultrastructural changes and irreversible damage, leading to severe HF and death. Many other cases do not demonstrate a decline in resting LVEF in the early stages of CTRCD due to myocardial compensation [7] Under these conditions, changes in leftventricular global longitudinal strain (GLS) appear earlier than CTRD, and GLS is a better predictor of CTRCD than LVEF [8]. Over the past two decades, many studies have been performed on CTRCD-related serum biomarkers such as troponin (Tn) and B-type natriuretic peptide (BNP) These serum biomarkers have obvious value in the early identification, assessment and monitoring of CTRCD. In this review we will cover recent literature describing subclinical CTRCD biomarkers

CANCER THERAPY AND CTRCD
Targeted Therapy
CLASSICAL BIOMARKERS
EMERGING BIOMARKERS
Positive results
Radiotherapy Anthracyclines
Biomarkers and Management of CTRCD
Immune response proteins
Findings
CONCLUSION AND PROSPECT
Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call