Biomarkers for the early detection of anthracycline-induced cardiotoxicity: current status.
BACKGROUND
Cardiotoxicity is a well-known and potentially serious complication of anticancer therapy. Anthracycline-based chemotherapy represents the greatest risk. Early detection of cardiotoxicity is crucial for applying preventive and supportive therapeutic strategies.


RESULTS
Various methods have been recommended for monitoring of cardiotoxicity. In our conditions, echocardiography and electrocardiography are routinely used. However, this approach shows low sensitivity for the early prediction of cardiomyopathy when the possibilities of appropriate management could still improve the patient's outcome. Recently, biomarkers of cardiac injury have been investigated in the assessment of chemotherapy-induced cardiotoxicity. Cardiospecific biomarkers, such as cardiac troponins, show high diagnostic efficacy in the early subclinical phase of the disease before the clinical onset of cardiomyopathy. Increase in their concentrations correlates with disease severity. As for natriuretic peptides, some studies, including ours, have shown promising results. Definitive evidence of their diagnostic and prognostic role in this context is still lacking and natriuretic peptides have not been routinely used for monitoring of cardiotoxicity in clinical practice. Other perspective biomarkers of cardiotoxicity in oncology are under study, especially heart-type fatty acid-binding protein (H-FABP) and glycogen phosphorylase BB (GPBB). Our studies using GPBB have provided encouraging results. However, the available data are limited and their practical use in this context cannot be recommended until their clinical efficacy is clearly defined.


CONCLUSIONS
This review covers the current status of biomarkers for the early detection of anthracycline-induced cardiotoxicity. The authors present in brief, their own experience with multiple biomarkers in the detection of cardiotoxicity.
Department of Internal Medicine, Faculty of Military Health Sciences, University of Defence, Hradec Kralove, Czech Republic.
Jan M
JM
Horacek
Martina
M
Vasatova
Radek
R
Pudil
Milos
M
Tichy
Pavel
P
Zak
Martin
M
Jakl
Ladislav
L
Jebavy
Jaroslav
J
Maly
D018943:Anthracyclines / Q000009:adverse effects*; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis*; D066126:Cardiotoxicity / Q000175:diagnosis* / Q000209:etiology; D006801:Humans
D018943:Anthracyclines; D000903:Antibiotics, Antineoplastic; D015415:Biomarkers