Nav: Home

Study finds key metabolic changes in patients with chemotherapy-associated cardiotoxicity

July 18, 2019

BOSTON - More and more patients are being treated successfully for cancer. However, some cancer treatments that are very effective for breast cancer - medications like anthracyclines and trastuzumab - can cause heart dysfunction and lead to heart failure. Heart-related side effects can limit the amount of cancer therapy that patients are eligible to receive. Currently, there is no effective way of predicting which patients will develop heart dysfunction during or after receiving these medications.

To learn more about the processes that lead to heart toxicity, a team of researchers at Beth Israel Deaconess Medical Center (BIDMC) embarked on a study to investigate whether early changes in energy-related metabolites in the blood - measured shortly after chemotherapy - could be used to identify patients who developed heart toxicity at a later time. The study, published in the Journal of Cardiovascular Translational Research, found that metabolites associated with the energy powerhouse of the cell - the mitochondria - changed differently in patients who later developed heart dysfunction compared to those who did not.

Using blood samples obtained from 38 patients treated with anthracyclines and trastuzumab for breast cancer, the researchers measured 71 energy-related metabolites. They then compared metabolite profiles between patients who developed heart toxicity and those who did not, identifying changes in citric acid and aconitic acid that differentiated the two groups of patients.

"In particular, levels of citric acid increased over time in patients who did not develop heart toxicity, but they remained the same or decreased in patients who did develop heart toxicity," said corresponding author Aarti Asnani, MD, Director of the Cardio-Oncology Program at BIDMC. "The ability to augment citric acid and related metabolites may be a protective response that is absent or defective in patients with heart toxicity." The researchers also observed changes in breakdown products of DNA that differentiated the two groups of patients.

"We hope these findings will ultimately lead to the development of biomarkers that could be used to determine which patients are at the highest risk of developing chemotherapy-related heart toxicity," said Asnani. "Identification of high-risk patients could allow us to consider medications that protect the heart before patients begin chemotherapy, or prompt the use of different chemotherapy regimens that are less toxic to the heart in those patients."

In their next phase of research to follow up on this pilot study, Asnani and colleagues will seek to confirm their results in larger patient populations.
-end-
In addition to Asnani, co-authors include Robert Gerszten, MD, Xu Shi, PhD, Laurie Farrell, RN, and Rahul Lall, PhD of BIDMC; Igal Sebag, MD, of Sir Mortimer B. Davis-Jewish General Hospital; Juan Carlos Plana Gomez, MD, of Baylor College of Medicine; and Marielle Scherrer-Crosbie, MD, PhD, of the Hospital of the University of Pennsylvania.

Asnani was supported by a Scholar Award from the Sarnoff Cardiovascular Research Foundation. The project was supported by an investigator-initiated grant from Susan G. Komen and a SPARK grant initiated by Massachusetts General Hospital.

The authors declare no competing interests.

About Beth Israel Deaconess Medical Center

Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding.

BIDMC is part of Beth Israel Lahey Health, a new health care system that brings together academic medical centers and teaching hospitals, community and specialty hospitals, more than 4,000 physicians and 35,000 employees in a shared mission to expand access to great care and advance the science and practice of medicine through groundbreaking research and education.

Beth Israel Deaconess Medical Center

Related Breast Cancer Articles:

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.
Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.
More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.
Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.
Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.
More Breast Cancer News and Breast Cancer Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...