Cardiac Dysfunction Related to Breast Cancer Treatment
Posted: Wednesday, May 20, 2020
Previous research has suggested that extracellular vesicles may be responsible for mediating intercellular communication and inducing phenotypic changes in recipient cells when transferring “biomolecular cargo.” Based on such findings, Dinesh Thavendiranathan, MD, of the Toronto General Hospital, and colleagues found that patients with HER2-positive breast cancer who develop cancer therapy–related cardiac dysfunction appeared to have distinct plasma extracellular vesicles before and after anthracycline treatment. The report, presented at the virtual 2020 American College of Cardiology (ACC) World Congress of Cardiology (Abstract 1015-07) and published in the Journal of the American College of Cardiology, suggested that plasma extracellular vesicles may show promise as a potential biomarker for subclinical cardiac injury and optimize protective treatment in patients who receive cancer therapy.
The researchers isolated extracellular vesicles from plasma samples of 20 women with stage I to III HER2-positive breast cancer who were undergoing treatment with anthracycline plus trastuzumab. Patients were stratified into two groups: those who experienced cancer therapy–related cardiac dysfunction (n = 10) and those who did not (n = 10).
When researchers analyzed the morphologic characteristics of the samples, the patients who developed cardiac dysfunction following anthracycline showed an increase in the size and abundance of extracellular vesicles (P < .01). These patients also showed distinct microRNA and proteomics signatures prior to anthracycline treatment, including microRNAs affiliated with angiogenesis and cardiac proteins. In patients who did not experience cardiac dysfunction related to cancer therapy, the most differentially expressed microRNAs reflected pathways of immune activation and oxidative responses.
In the future, the researchers suggested trials with bigger sample sizes aimed at developing a greater mechanistic understanding of biologically relevant targets. They also will attempt to validate these findings using secondary models and additional patient groups.
Disclosure: The study authors reported no conflicts of interest.