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MicroRNA Expression Pre-Trastuzumab Treatment in HER-2+ Early Breast Cancer Patients as a Predictor of Cancer Therapy-Related Cardiac Dysfunction: A Pilot Cohort Study

  • 0Post-Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
Cardiology +

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September 8, 2025

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September 8, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

This pilot study found that elevated levels of specific microRNAs (miRNAs) before trastuzumab (TTZ) treatment may predict cancer therapy-related cardiac dysfunction (CTRCD) in HER2-positive breast cancer patients. Further research is needed to confirm these promising miRNA biomarkers for cardiotoxicity risk.

Area Of Science

  • Cardiology
  • Oncology
  • Genetics

Background

  • Cancer therapy-related cardiac dysfunction (CTRCD) prediction remains challenging with traditional biomarkers.
  • MicroRNAs (miRNAs) show potential as novel biomarkers for identifying high-risk patients.
  • Limited research exists on miRNA utility in HER2-positive breast cancer patients undergoing trastuzumab (TTZ) therapy.

Purpose Of The Study

  • To investigate the predictive value of six serum-derived circulating miRNAs for CTRCD development.
  • To assess these miRNAs in early-stage HER2-positive breast cancer patients receiving TTZ.
  • To identify potential novel biomarkers for cardiotoxicity risk assessment.

Main Methods

  • Prospective cohort study of 47 female patients with HER2-positive early breast cancer.
  • Blood samples collected before TTZ initiation for miRNA quantification (let-7f-5p, miR-1-3p, miR-20a-5p, miR-126-3p, miR-130-3p, miR-210a-3p) via quantitative real-time PCR.
  • CTRCD defined as >10% reduction in left ventricular ejection fraction to <53%; survival analysis using Kaplan-Meier curves.

Main Results

  • Six patients (12.8%) developed CTRCD during a median follow-up of 14.2 months.
  • High baseline expression of miR-20a-5p, miR-126-3p, miR-130-3p, and miR-210-3p predicted significantly reduced CTRCD-free survival (p < 0.05).
  • Elevated miR-126-3p and miR-130-3p demonstrated 100% sensitivity for predicting CTRCD.

Conclusions

  • Elevated baseline expression of certain miRNAs (miR-126-3p, miR-130-3p) may indicate an increased risk of CTRCD in patients receiving TTZ.
  • These miRNAs warrant further investigation as potential predictive biomarkers for cardiotoxicity.
  • Larger prospective studies are necessary to validate these preliminary findings.

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