The Cardiac Markers and Oxidative Stress Parameters in Advanced Non-Small Cell Lung Cancer Patients Receiving Cisplatin-Based Chemotherapy.
BACKGROUND
Cardiotoxicity is a well known long-term consequence of lung cancer chemotherapy, however little is known about early subclinical changes in cardiac function.


OBJECTIVE
The goal of the study was to assess early cardiotoxic effects of cisplatin-containing chemotherapy in stage III and IV lung cancer patients, measuring serum levels of selected cardiac markers in relation to oxidant effects.


METHODS
We quantified the immediate impact of chemotherapy on cardiac troponin T (TnT), creatine kinase-myocardial band (CK-MB) and N- terminal pro-brain natriuretic peptide (NT-proBNP) in blood samples obtained from 12 non-small cell lung cancer (NSCLC) patients. All markers were measured using commercially available immunoassays. To investigate the oxidant effects of cisplatin-containing chemotherapy, we evaluated reduced glutathione (GSH), nitrite (NO2), derivatives of reactive oxygen metabolites (d-ROMs) and thiols (SH). Samples were collected prior to chemotherapy and 1 day after the first cycle of cisplatin administration.


RESULTS
Chemotherapy did not cause statistically significant elevations in serum CK-MB. Serum TnT levels were undetectable at both time points in 11 out of 12 patients with a threshold of 0.01 ng/ml. In the single patient with undetectable TnT at the baseline, after the first infusion TnT level reversibly rose to 0.03 ng/ml. The pre-treatment value of NT-proBNP was slightly elevated in 7 out of 12 lung cancer patients. In 1 case NT-proBNP level significantly increased after chemotherapy (from 221.8 to 1489.0 pg/ml p<0.001), in the remaining 11 patients it was stable Cisplatin-based combination chemotherapy induced significant nitrite production in 5 patients (p<0.05). The other measured oxidative stress parameters remained unchanged after the first infusion.


CONCLUSIONS
This pilot study demonstrated occasional elevations of cardiac biomarkers during cisplatin administration. Administration of cisplatin-containing chemotherapy caused significant nitroxidative stress in some patients. The relevance of cardiovascular complications in cancer patients and identification individual risk factors of developing cardiovascular toxicity merit further evaluation.
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw , Marszalkowska 24, 00-576 Warsaw, Poland.
Urszula
U
Demkow
Institute of Tuberculosis and Lung Diseases , Plocka 26, 01-135 Warsaw, Poland.
Beata
B
Biatas-Chromiec
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw , Marszalkowska 24, 00-576 Warsaw, Poland.
Anna
A
Stelmaszczyk-Emmel
Institute of Tuberculosis and Lung Diseases , Plocka 26, 01-135 Warsaw, Poland.
Elzbieta
E
Radzikowska
Institute of Tuberculosis and Lung Diseases , Plocka 26, 01-135 Warsaw, Poland.
Elzbieta
E
Wiatr
Institute of Tuberculosis and Lung Diseases , Plocka 26, 01-135 Warsaw, Poland.
Piotr
P
Radwan-Rohrenschef
Institute of Tuberculosis and Lung Diseases , Plocka 26, 01-135 Warsaw, Poland.
Monika
M
Szturmowicz
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