title: Acceptable cardiac safety profile of neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide and celecoxib (FEC-C) for breast cancer: a subanalysis of biomarkers for cardiac injury.
abstract: OBJECTIVE
  This substudy aimed to examine the changes in biomarkers for cardiac injury in patients who received neoadjuvant 5-fluorouracil, epirubicin, cyclophosphamide with concurrent celecoxib (FEC-C).
  
  
  METHODS
  Thirty-four female patients with histologically confirmed locally advanced breast cancer preoperatively received 3 cycles of FEC-C (500 mg/m2, 75 mg/m2, 500 mg/m2) with concurrent celecoxib (400 mg bid). Blood samples were drawn from patients on day (D) 0, D3, D21, D42, and D63 (end of therapy), and the serum levels of lactate dehydrogenase (LDH) and plasma levels of cardiac troponin I (cTnI) and N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) were measured with commercially available test kits.
  
  
  RESULTS
  All patients tolerated this regimen well. Neither life-threatening toxicity nor clinical symptoms of cardiac damage were observed. Serum LDH increased significantly from baseline after 3 cycles of FEC-C (p<0.0001), but the change was possibly brought about by chemotherapy-induced liver derangement. However, NT-proBNP decreased significantly (p=0.009), while cTnI increased nonsignificantly (p=0.078) after 3 cycles of FEC-C compared to baseline, although this increase was still regarded as normal.
  
  
  CONCLUSIONS
  Short-term use of the FEC-C regimen has proven to be effective in locally advanced breast cancer, with an acceptable cardiac safety profile.
authors.affiliation: Organisation for Oncology and Translational Research, Hong Kong, PR China. lwcchow@ootr.org
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Chow
authors.forename: Wings T Y
authors.initials: WT
authors.lastname: Loo
authors.forename: Adrian Y S
authors.initials: AY
authors.lastname: Yip
authors.forename: Elizabeth L Y
authors.initials: EL
authors.lastname: Ng
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy*; D000068579:Celecoxib; D017024:Chemotherapy, Adjuvant; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D015251:Epirubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006331:Heart Diseases / Q000097:blood* / Q000139:chemically induced; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011720:Pyrazoles / Q000008:administration & dosage; D013449:Sulfonamides / Q000008:administration & dosage; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D019210:Troponin I; D015251:Epirubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D000068579:Celecoxib; D005472:Fluorouracil