title: The role of cardiac biomarkers as predictors of trastuzumab cardiotoxicity in patients with breast cancer.
abstract: OBJECTIVE
  Identification of patient with increased risk of cardiotoxicity would allow not only prevention and early diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy.
  
  
  METHODS
  Fifty-two women with HER2(+) breast cancer treated with trastuzumab were included in this study. Patients were prospectively followed with routine cardiac evaluation. Before and after administration of trastuzumab blood samples for NT-proBNP were also taken.
  
  
  RESULTS
  The median age was 48.5 year (range: 26-74). Hypertension and obesity were two most common co-morbidities. The median duration application of trastuzumab was 52 weeks. During median 14.5 (3-33) months follow-up cardiac adverse events occurred in 5 (9.6%) patients and 2 out of 5 was grade III-IV heart failure. Both patients had preserved left ventricular ejection fraction and no symptom of heart failure before trastuzumab but older than 65 years old and had diabetes mellitus and obesity. High level of NT-proBNP (> 300 ng/ml) was observed in both patients and heart failure recovery was not observed. There was statistically significant difference regarding body mass index (p = 0.004) and diabetes mellitus (p = 0.002) between patients with and without cardiotoxicity.
  
  
  CONCLUSIONS
  Although, cardiac biomarkers still cannot replace routine cardiac monitoring, natriuretic peptides may provide additional tool for detection of patients with high risk of cardiotoxicity and early detection of cardiotoxicity.
authors: Department of Medical Oncology,Gaziantep Dr. Ersin Arslan State Hospital, Gaziantep 27310, Turkey.
authors: Y
authors: Y
authors: Ürun
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: G
authors: G
authors: Utkan
authors: Department of Medical Oncology,Yildirim Beyazit University School of Medicine, Atatürk Education and Research Hospital, Ankara 06800, Turkey.
authors: B
authors: B
authors: Yalcin
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: H
authors: H
authors: Akbulut
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: H
authors: H
authors: Onur
authors: Department of Biostatistics,Ankara University School of Medicine, Ankara 06100, Turkey.
authors: D G
authors: DG
authors: Oztuna
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: F C
authors: FC
authors: Şenler
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: A
authors: A
authors: Demirkazık
authors: Department of Medical Oncology, Ankara University School of Medicine, Ankara 06590, Turkey.
authors: F
authors: F
authors: İçli
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use / Q000633:toxicity*; D000970:Antineoplastic Agents / Q000627:therapeutic use / Q000633:toxicity*; D015415:Biomarkers / Q000097:blood; D001940:Breast / Q000187:drug effects; D001943:Breast Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D066126:Cardiotoxicity / Q000097:blood* / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000068878:Trastuzumab