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Anthracycline Drugs May Increase the Risk of Heart Failure Among Breast Cancer Patients

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Highlights
  • Anthracycline drugs were found to increase the risk of heart damage in breast cancer patients.
  • A research team from the Indiana University analyzed the genome wide association data collected from breast cancer patients who received doxorubicin drug.
  • Single-Nucleotide polymorphisms (SNPs) were associated with anthracycline-induced heart failure in breast cancer patients.

Anthracycline Drugs May Increase the Risk of Heart Failure Among Breast Cancer Patients

Breast cancer patients with certain type of genetic biomarkers were found to have an increased risk of anthracycline-induced congestive heart failure, finds a study from Indiana University.

The research study was published in the American Journal for Cancer Research, Clinical Cancer Research.

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Bryan P. Schneider, Associate professor of medicine, Indiana University, explained that chemotherapy for breast cancer patients may vary from one person to another because of the potential side effects of the treatment. It is therefore better that oncologists and patients understand the potential benefits and risks associated with therapy while making treatment decisions.

Schneider said, "Anthracyclines such as doxorubicin, which are widely used chemotherapeutic agents, cause congestive heart failure in about 1 to 2 percent of patients."
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"Knowing which patients are at increased risk for this life-threatening effect of anthracycline chemotherapy is important to help oncologists counsel patients about their personal risks and benefits of such treatment," he added.

Research Study
The research team conducted the study by analyzing the genome-wide association data collected from 3431 breast cancer patients who received doxorubicin drug for treatment. These patients were enrolled in the phase III Eastern Cooperative Oncology Group (ECOG) 5103 clinical trial and heart assessment details for these patients were available.

Around 68 patients from the group were found to have congestive heart failure confirmed by cardiologist. Out of which 51 patients were found to be European-American. Gene associated analysis was limited to European-American. However, several single nucleotide polymorphisms (SNPs) were found to be associated with the risk of anthracycline-induced congestive heart failure.

Single-Nucleotide Polymorphism (SNP) is a variation in the DNA sequence of the genome.

The research team chose two of the top SNPs for validating data. One of the SNP, rs28714259 was found to be associated with anthracycline induced congestive heart failure(2415 patients) and low ventricular ejection fraction (a sign of heart damage) in 828 patients.

Schneider said that, "We found that the A allele of the single nucleotide polymorphism (SNP) rs28714259 was associated with increased risk of anthracycline-induced congestive heart failure among women with breast cancer."

"Adding information gained from testing for this SNP to currently used clinical information could help oncologists provide a more precise prediction of the risks and benefits of anthracycline chemotherapy for patients with breast cancer. We are currently further testing this finding in patients receiving anthracyclines at the Indiana University Melvin and Bren Simon Cancer Center to better understand its contribution to heart failure risk in the face of other known risk factors and comorbidities."

Study Limitations
  • The clinical trials of all the study did not follow the same method of assessing heart damage.
  • The number of patients associated with heart damage were less as it is a rare adverse effect.
The author also concluded that more number of studies is required to confirm the association of heart damage with anthracycline chemotherapy.

Anthracyclines
  • Anthracycline is a certain type of antibiotic produced by Streptomyces bacteria. They mainly act by damaging the DNA of the cancer cells.
  • Examples of anthracycline drugs include doxorubicin, daunorubicin and epirubicin.
  • They are widely used for the treatment of breast, bladder, ovaries, lung and stomach cancer.
Side Effects of Anthracyclines
  • Cardiotoxicity - Cardiac failure, heart damage.
  • Acute Myelogenous Leukemia (AML) - Cancer of the blood cells pertaining to the bone marrow.
References :
  1. Anthracyclines - ( http://www.toxipedia.org/display/toxipedia/Anthracyclines)
  2. Single-nucleotide polymorphism - (http://isogg.org/wiki/Single-nucleotide_polymorphism)


Source: Medindia

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