The relation between soluble apoptotic proteins and subclinical cardiotoxicity in adjuvant-treated breast cancer patients.
BACKGROUND
Circulating apoptotic proteins are increased in heart failure patients. We evaluated whether circulating soluble apoptosis-related protein levels change after anthracycline-containing chemotherapy and radiotherapy in relation to cardiac dysfunction or the applied treatment.


METHODS
Circulating apoptotic proteins were measured with immunoassay in 40 breast cancer patients following surgery (TO), one month (T1) and one year (T2) after epirubicin-based chemotherapy. Standard-dose (n=21) or high-dose (n=19) myeloablative chemotherapy, preceded irradiation and tamoxifen. Circulating apoptotic proteins were compared with previous cardiac evaluations.


RESULTS
Soluble tumor necrosis factor receptor 1 (+30%), 2 (+43%) and Fas (+40%) were transiently increased at T1 compared to T0, whereas Fas ligand (-64%) was transiently decreased, especially in the high-dose group. Apoptosis markers were not associated with cardiac dysfunction.


CONCLUSIONS
Significant, but transient changes in soluble apoptotic protein levels were observed, particularly after high-dose chemotherapy. No relation was found between apoptosis-related proteins and cardiotoxicity.
Perik
Patrick J
PJ
Department of Medical Oncology, Thorax Center, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB, Groningen, Germany.
De Vries
Elisabeth G E
EG
Boomsma
Frans
F
Messerschmidt
Juergen
J
Van Veldhuisen
Dirk J
DJ
Sleijfer
Dirk T
DT
Gietema
Jourik A
JA
Van der Graaf
Winette T A
WT
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017209:Apoptosis; D001798:Blood Proteins / Q000032:analysis*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy*; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006321:Heart / Q000187:drug effects*; D006801:Humans; D013629:Tamoxifen / Q000008:administration & dosage
D001798:Blood Proteins; D013629:Tamoxifen; D015251:Epirubicin; D003520:Cyclophosphamide; D005472:Fluorouracil