Biomarkers could tag chemo heart risk

A combination of biomarkers and imaging could tag chemotherapy-induced heart damage early on, cutting long-term heart risk in cancer survivors, according to a study reported at the recent San Antonio Breast Cancer Symposium.

Anthracycline drugs such as doxorubicin are commonly used in cancer treatment, especially breast cancer and childhood cancers, but they can cause heart damage. As more people--especially children--are surviving cancer and living on for many years, preventing these long-term effects is becoming increasingly important. Picking out the people at risk would pinpoint those who should receive either heart-safe chemotherapies or drugs that protect the heart muscle against damage.

The researchers focused on circulating epithelial progenitor cells (EPCs) as a potential biomarker for heart damage, as these are already used as markers in heart attacks and heart disease, and used cardiac magnetic resonance imaging (CMR) to look at physical changes to the heart muscle. They compared the results with blood levels of troponin and BNP, two existing heart damage biomarkers.

The people with lower levels of EPCs had higher levels of troponin, and were more likely to have physical changes in the heart even before they showed any acute symptoms of heart damage.

"By pairing CMR with measuring the amount of chemical messengers in the bloodstream, we're building a solid foundation that may help us develop a predictive model in the future," Subha Raman at Ohio State University's Wexner Medical Center said in a press release.

The next step is to check the patients at 12 and 24 months, and then to follow them for up to 5 years if possible.

- read the press release