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Pretreatment Circulating Vascular Biomarkers Predict Cancer Therapy-Related Cardiac Dysfunction During HER2+ Breast
Dakota Gustafson1, Priya Mistry1, Crizza Ching2
1Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada.
Predicting cancer therapy-related cardiac dysfunction (CTRCD) risk in HER2-positive breast cancer patients is crucial. Pretreatment endothelial and inflammatory biomarkers show promise in identifying patients at high risk for CTRCD during chemotherapy.
Area of Science:
- Cardiology and Oncology
- Biomarker Discovery
- Precision Medicine
Background:
- Limited availability of blood biomarkers to predict cancer therapy-related cardiac dysfunction (CTRCD).
- Need for predictive markers in HER2-positive breast cancer patients undergoing cardiotoxic therapies.
Purpose of the Study:
- Identify circulating biomarkers for predicting CTRCD risk in HER2-positive breast cancer patients.
- Evaluate endothelial activation, inflammation, and microRNA profiles for CTRCD prediction.
Main Methods:
- Multiomics profiling of biomarkers (proteins, microRNAs) in patients receiving anthracycline and trastuzumab.
- Serial cardiac assessments using cardiac magnetic resonance imaging (CMR) and echocardiography.
- Validation of pretreatment biomarkers in an independent cohort.
Main Results:
- Elevated pretreatment inflammatory markers (myeloperoxidase, interferon-gamma-induced protein-10) and endothelial markers (angiopoietin-2, endoglin) associated with CTRCD development.
- Distinct microRNA signatures identified in patients who developed CTRCD.
- A predictive model integrating biomarkers outperformed clinical and CMR measures.
Conclusions:
- Pretreatment endothelial-centric and inflammatory biomarkers are superior to clinical and CMR measures for predicting CTRCD.
- These biomarkers offer a promising approach for early risk stratification in HER2-positive breast cancer patients.
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