Abstract 3930: A prospective pilot study of kinetics of high sensitivity troponin T (hs-TnT) and amino terminal (nt-proBNP) in breast cancer patients (pts) treated with doxorubicin (A) or trastuzumab (T)

Proceedings: AACR 107th Annual Meeting 2016; April 16-20, 2016; New Orleans, LA Introduction: A and T are associated with the development of cardiac dysfunction. The kinetics of cardiac biomarkers early after A or T treatment (Rx) is undefined. Methods: We studied hs-TnT (detection limit: 3 ng/ml, myocardial infarction threshold 14 ng/ml) and nt-proBNP (detection limit: 5 pg/ml) levels just prior to (baseline), and on days +1, +2, +3 and +7 during the first and second cycle in breast cancer pts treated with A (n = 11) or T (n = 11). Baseline and peak values for each cycle, baseline to baseline, peak to peak, time to peak, and baseline corrected area under the curve (AUC) were calculated. Study No. [NCT01771549][1] Results: Group (grp) A pts were younger, 51 ± 18 years, than T grp pts, 60 ± 13 years. Three pts in A grp and 4 pts in T grp used antihypertensives. Baseline ejection fraction (EF) was 52-68% (A grp) and 56-69% (T grp). Hs-TnT was undetectable in 5/11 A grp, and 2/11 T grp pts at baseline. By cycle 2 day +1, all A pts had a detectable level of hs-TnT (p = 0.03) compared to 7/11 T pts. Median time to peak level for hs-TnT was 1.5 days for the A grp and 1.2 days for the T grp (NS). In the A grp, significant transient increase in nt-proBNP were also seen (Table). In the T grp, a significant rise in nt-proBNP was not seen in cycle 1 but was seen on cycle 2 day +1 and cycle 2 peak. AUC values were positive for hs-TnT in A pts but not in T pts, and were positive for nt-proBTNP for both A and T. Only 1 pt in A grp had symptomatic EF decline (47%) three months from start of A. None of T grp pts had EF decline. Conclusion: A, but not T was associated with increase in pre-Rx (cycle 2 only), peak, and AUC hs-TnT levels for cycles 1 and 2 with peak values occurring 1.5 days post-Rx. This study evaluating serial kinetics of cardiac biomarker in pts receiving A or T therapy, suggests that assessment of pre- and day +2 post-Rx values could be a means of quantifying cumulative myocardial injury over the chemotherapy course. *Roche Diagnostics Corp, Indianapolis, IN provided assay reagent kits. | hs-TnT, ng/ml | A, cycle 1 | A, cycle 2 | P-val | T, cycle 1 | T, cycle 2 | P-val | | ------------------ | ---------- | ----------- | ------------------------------------------- | ---------- | ---------- | ----- | | Baseline | 4.6 | 9.3 | <0.002 | 7.7 | 5.0 | NS | | Peak | 9.6** | 16.1† | <0.002 | 8.0 | 6.8 | NS | | Time to peak, days | 1.6 | 1.5 | NS | 1.1 | 1.3 | NS | | AUC above baseline | 7.1±13.4 | 27±19 | <0.001 | -1.4±7.2 | -5±17 | NS | | nt-proBNP, pg/ml | A, cycle 1 | A, cycle 2 | P-val | T, cycle 1 | T, cycle 2 | P-val | | Baseline | 94 | 90 | NS | 124 | 80 | NS | | Peak | 361* | 359* | NS | 209 | 206† | NS | | Time to peak, days | 1.8 | 1.9 | NS | 2.2 | 1.8 | NS | | AUC above baseline | 423 | 499 | NS | 78** | -32** | <0.5 | | *p 0.05) | **p<0.03 | | | Citation Format: Pooja Advani, Jonathan Hoyne, Alvaro Moreno-Aspitia, Marcia Dubin, Shelly Brock, Caroline Harlow, Tammy Wollett, Saranya Chumsri, Joseph Blackshear. A prospective pilot study of kinetics of high sensitivity troponin T (hs-TnT) and amino terminal (nt-proBNP) in breast cancer patients (pts) treated with doxorubicin (A) or trastuzumab (T). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3930. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01771549&atom=%2Fcanres%2F76%2F14_Supplement%2F3930.atom