Table 3.
Novel biomarkers for prediction of cardiac toxicity.
| BIOMARKERS | MECHANISMS | MAIN FINDINGS | REF. |
|---|---|---|---|
| hs-CRP | Non-specific marker of inflammation | – Correlations between hs-CRP levels and LV mass, wall thickness and dimension in patients with acute lymphoblastic leukemia independently of exposure to anthracycline | 30 |
| IL-6 ROS TAOS MPO |
Markers of inflammation and oxidative stress | – Correlations between increases in IL-6 and ROS and reduction of LV systolic function in anthracycline-treated patients | 45 |
| – Decrease in TAOS correlates with anthracycline cumulative dose. Changes in antioxidant defense capacity might explain cardiotoxicity | 46 | ||
| – Increase from baseline to 3 months in cTnI (HR = 1.38) and MPO (HR = 1.34) are associated with increased risk of cardiotoxicity following anthracycline, taxanes, and trastuzumab treatement | 47 | ||
| Fibrinogen vWF t-PA PAI-1 ICAM-1 |
Markers of endothelial dysfunction | – Testicular patients receiving cisplatin-based therapy have higher levels of fibrinogen, vWF, PAI-1 and t-PA compared to those who do not | 49,50 |
| – Patients with a PAI-1 > 43 ng/mL have a higher risk of metabolic syndrome | |||
| – Patients treated by cisplatin have higher levels of ICAM-1 compared to those who are not | |||
| FABP GPBB |
Markers of early detection of myocardial ischemia and necrosis | – Higher FABP level 24 hours after anthracycline-based therapy predicts cardiac toxicity defined as LVEF ≤ 50% | 51 |
| – Increased release of GPBB (>7.30 g/L) after anthracycline is considered a sign of acute subclinical cardiotoxicity | 52 | ||
| Neuregulin-1 | Paracrine growth factor released by endothelial cells that binds to ErbB receptors promoting cell growth, survival and repair | – NRG-1/ErbB regulates anthracycline-induced myofilament injury, and increased susceptibility of myofilaments to anthracycline in the presence of ErbB may explain cardiotoxicity | 54,55 |
| – Patients with greater decline in LVEF have higher NRG-1 level at baseline |
Abbreviations: FABP, fatty acid binding protein; GPBB, glycogen phosphorylase BB; hs-CRP, high-sensitivity C-reactive protein; ICAM-1, intercellular adhesion molecule-1; IL-6, interleukin-6; LVEF, left ventricular ejection fraction; MPO, myeloperoxidase; NRG-1, neuregulin-1; PAI-1, plasminogen activator inhibitor; ROS, reactive oxygen species; TAOS, total antioxidant status; t-PA, tissue-type plasminogen activator; vWF, von Willebrand factor.