Evaluating Cardiotoxicity of HER-2 Targeted Drugs for Breast Cancer

Breast cancer is the most common cancer in women worldwide. Approximately 15-20% of breast cancer cases are Human Epidermal Growth Factor Receptor (HER2)-positive. The overexpression of the HER2 protein promotes the growth and spread of cancer cells, indicating a poorer prognosis in these patients. Therapies, known as anti-HER2 drugs, specifically target the HER2 protein and inhibit its activity, thus improving the survival of patients with HER2 positive breast cancer. 

Evaluating Cardiotoxicity of HER-2 Targeted Drugs for Breast Cancer

One known side effect of HER-2 targeted therapies is cardiotoxicity which is characterized by left ventricular systolic dysfunction. Identifying cardiac dysfunction in HER2 positive breast cancer patients is crucial in order to prevent the development of heart failure in these patients. Monitoring cardiac function through imaging methods is mandatory for HER2-positive breast cancer patients. However, considering the possibility of cardiac damage even if there are no evident changes in heart function could be beneficial. Therefore, biomarkers could be useful in assessing early cardiac dysfunction in these patients.

Evaluating Cardiotoxicity of HER-2 Targeted Drugs for Breast Cancer: 

The cardiac biomarkers  NT-proBNP and NT-proANP

N-terminal pro-brain natriuretic peptide (NT-proBNP – amino acids 1-76) and N-terminal pro-atrial natriuretic peptide (NT-proANP – amino acids 1-98) are secreted from the cardiac ventricles and atria, respectively. The half-lives and stability of both analytes are more reliable than their biologically active peptides (BNP and ANP).

In a recent study researchers evaluated patients diagnosed with HER-2 positive breast cancer who underwent treatment with HER2 inhibitors and measured serum levels of the cardiac biomarkers NT-proBNP and NT-proANP using the assays from Biomedica. Learn more:

Evaluating Cardiotoxicity in Breast Cancer Patients Treated with HER2 Inhibitors: Could a Combination of Radionuclide Ventriculography and Cardiac Biomarkers Predict the Cardiac Impact?

Ready tp use kits developed & manufactured by BIOMEDICA

 

NT-proBNP ELISA Assay (cat. no SK-1204)

•  For the detection of human NT-proBNP
• CE.marked – for IVD use in the EU
• Flexible – can be run in every lab
• 20µl sample volume (serum/plasma)
• Assay time – 3 h / 30 min
• Two controls and ready to use calibrators included
• Regular proficiency testing –“Proficiency Testing Certificate”

 

NT-proANP ELISA Assay (cat. no BI-20892)

• For the detection of human NT-proANP (assay suitable also for detection of NT-proANP in rat and mouse samples)
• Two controls and ready to use calibrators included
• 50µl sample volume (serum/plasma)
• Assay time – 3 h / 30 min

 

Related products

Rat NT-proBNP ELISA assay (cat. no. BI-1204R)

• 10 µl sample volume
• sample values provided

 

Related literature

Evaluating Cardiotoxicity in Breast Cancer Patients Treated with HER2 Inhibitors: Could a Combination of Radionuclide Ventriculography and Cardiac Biomarkers Predict the Cardiac Impact? Gherghe M, Lazar AM, Mutuleanu MD, Bordea CI, Ionescu S, Mihaila RI, Petroiu C, Stanciu AE. Cancers (Basel). 2022 Dec 29;15(1):207. doi: 10.3390/cancers15010207. PMID: 36612202; PMCID: PMC9818586.

Abstract

(1) Background: The aim of our study was to determine whether monitoring cardiac function through RNV and cardiac biomarkers could predict the cardiac impact of combined therapy with trastuzumab, pertuzumab and docetaxel, which are regularly used nowadays to treat HER2-positive breast cancer. (2) Methods: This prospective monocentric study included 22 patients, diagnosed with HER2-positive breast cancer, who had their LVEFs and cardiac biomarkers evaluated both at the beginning of their treatment and after 6 months. Among all of the enrolled patients, two blood specimens were collected to assess circulating cardiac biomarkers. RNV was performed in each patient after “in vivo” radiolabeling of the erythrocytes. The obtained results were then statistically correlated. (3) Results: The average LVEF decrease between the two time points was approximately 4%. Of the five biomarkers we considered in this paper, only NT-proBNP correlated with the LVEF values obtained both in the baseline study and after 6 months of follow-up (r = -0.615 for T0 and r = -0.751 for T1, respectively). ST2/IL-33R proved statistically significant at the T1 time point (r = -0.547). (4) Conclusions: A combination of LVEF, NT-proBNP and ST2/IL-33R assessment may be useful for early detection of cardiac impairment in breast cancer patients treated with trastuzumab, pertuzumab and docetaxel.

NT-proBNP correlates with LVEF decline in HER2-positive breast cancer patients treated with trastuzumab. Bouwer NI, Liesting C, Kofflard MJM, Sprangers-van Campen SM, Brugts JJ, Kitzen JJEM, Fouraux MA, Levin MD, Boersma E. Cardiooncology. 2019 May 28;5:4. doi: 10.1186/s40959-019-0039-4. PMID: 32154011; PMCID: PMC7048136.

NT-proBNP as predictor factor of cardiotoxicity during trastuzumab treatment in breast cancer patients. Blancas I, Martín-Pérez FJ, Garrido JM, Rodríguez-Serrano F. Breast. 2020 Dec;54:106-113. doi: 10.1016/j.breast.2020.09.001. Epub 2020 Sep 11. PMID: 32977298; PMCID: PMC7511727.