Soluble urokinase plasminogen activator receptor and cardiotoxicity in doxorubicin-treated breast cancer patients: a prospective exploratory study

Jian Chu, Lillian Tung, Issam Attalah, Changli Wei, Melody Cobleigh, Ruta Rao, Steven B. Feinstein, Lydia Usha, Kathrin Banach, Jochen Reiser, Tochukwu M. Okwuosa

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Soluble urokinase plasminogen activator receptor is an inflammatory biomarker that may prognosticate cardiovascular outcomes. We sought to determine the associations between soluble urokinase plasminogen activator receptor and established markers of cardiotoxicity in breast cancer patients receiving doxorubicin. Methods: We conducted a prospective cohort study of women with newly diagnosed breast cancer receiving standard-dose doxorubicin (240 mg/m2) at Rush University Medical Center and Rush Oak Park Hospital (Chicago, IL) between January 2017 and May 2019. Left ventricular ejection fraction, global longitudinal strain, and cardiac biomarkers (N-terminal prohormone B-type natriuretic peptide, troponin-I, and high-sensitivity C-reactive protein) were measured at baseline and at intervals up to 12-month follow-up after end of treatment. The associations between soluble urokinase plasminogen activator receptor and these endpoints were evaluated using multivariable mixed effects linear regression. Results: Our study included 37 women (mean age 47.0 ± 9.3 years, 60% white) with a median baseline soluble urokinase plasminogen activator receptor level of 2.83 ng/dL. No participant developed cardiomyopathy based on serial echocardiography by one-year follow-up. The median percent change in left ventricular strain was -4.3% at 6-month follow-up and absolute changes in cardiac biomarkers were clinically insignificant. There were no significant associations between soluble urokinase plasminogen activator receptor and these markers of cardiotoxicity (all p > 0.05). Conclusions: In this breast cancer cohort, doxorubicin treatment was associated with a very low risk for cardiotoxicity. Across this narrow range of clinical endpoints, soluble urokinase plasminogen activator receptor was not associated with markers of subclinical cardiotoxicity. Further studies are needed to clarify the prognostic utility of soluble urokinase plasminogen activator receptor in doxorubicin-associated cardiomyopathy and should include a larger cohort of leukemia and lymphoma patients who receive higher doses of doxorubicin.

Original languageEnglish (US)
Article number3
JournalCardio-Oncology
Volume10
Issue number1
DOIs
StatePublished - Dec 2024
Externally publishedYes

Keywords

  • B-type natriuretic peptide (BNP)
  • Biomarker
  • Breast cancer
  • Cardiotoxicity
  • Doxorubicin
  • Echocardiography
  • Global longitudinal strain (GLS)
  • Soluble urokinase Plasminogen Activator Receptor (suPAR)
  • Troponin

ASJC Scopus subject areas

  • Oncology
  • Cardiology and Cardiovascular Medicine

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