title: Serum biomarkers for the detection of cardiac toxicity after chemotherapy and radiation therapy in breast cancer patients.
abstract: Multi-modality cancer treatments that include chemotherapy, radiation therapy, and targeted agents are highly effective therapies. Their use, especially in combination, is limited by the risk of significant cardiac toxicity. The current paradigm for minimizing cardiac morbidity, based on serial cardiac function monitoring, is suboptimal. An alternative approach based on biomarker testing, has emerged as a promising adjunct and a potential substitute to routine echocardiography. Biomarkers, most prominently cardiac troponins and natriuretic peptides, have been evaluated for their ability to describe the risk of potential cardiac dysfunction in clinically asymptomatic patients. Early rises in cardiac troponin concentrations have consistently predicted the risk and severity of significant cardiac events in patients treated with anthracycline-based chemotherapy. Biomarkers represent a novel, efficient, and robust clinical decision tool for the management of cancer therapy-induced cardiotoxicity. This article aims to review the clinical evidence that supports the use of established biomarkers such as cardiac troponins and natriuretic peptides, as well as emerging data on proposed biomarkers.
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Sibo
authors.initials: S
authors.lastname: Tian
authors.affiliation: Division of Medical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Kim M
authors.initials: KM
authors.lastname: Hirshfield
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Salma K
authors.initials: SK
authors.lastname: Jabbour
authors.affiliation: Division of Medical Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Toppmeyer
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Bruce G
authors.initials: BG
authors.lastname: Haffty
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Atif J
authors.initials: AJ
authors.lastname: Khan
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey and Rutgers Robert Wood Johnson Medical School , New Brunswick, NJ , USA.
authors.forename: Sharad
authors.initials: S
authors.lastname: Goyal
keywords: breast cancer; cardiac biomarkers; cardiotoxicity; chemotherapy; radiation therapy