Biomarker-Guided Cardioprotection for Patients Treated With Anthracyclines

What is the feasibility, safety, and exploratory efficacy of using the biomarker N-terminal pro–B-type natriuretic peptide (NT-proBNP) to guide cardioprotection during cardiotoxic cancer therapy?This randomized clinical trial with 100 participants demonstrated strong recruitment and retention rates and no significant differences in adverse events between an NT-proBNP–guided approach and usual care. At 3 months, left ventricular ejection fraction was modestly higher in the NT-proBNP–guided arm compared with usual care.These findings provide the first proof of concept that a monitoring strategy using cardiac stress biomarkers in patients receiving anthracycline chemotherapy could be feasible and safe, and may potentially affect cardiac structure and function.

Corresponding Author: Bonnie Ky, MD, MSCE, Thalheimer Center for Cardio-Oncology, Abramson Cancer Center, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA 19104 (bonnie.ky@pennmedicine.upenn.edu).

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