Abstract:
Cardiotoxicity is a side effect of chemotherapy in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients receiving both anthracyclines and trastuzumab. We looked for a possible protective effect of rosuvastatin against chemotherapy-induced cardiotoxicity. Methods: 50 newly diagnosed HER2 positive breast cancer patients were randomly allocated into two groups: 25patients in each. Group 1(control group) received doxorubicin for 4 cycles (3 months) followed by trastuzumab adjuvant therapy. Group 2 (treatment group) received doxorubicin for 4 cycles (3 months) followed by trastuzumab adjuvant therapy and 20 mg of oral rosuvastatin 24 h before the first cycle of chemotherapy and once daily for the rest of the follow-up period (6 months). Transthoracic echocardiography was done, and blood samples were collected for patients 24 h before the initiation of therapy, after 3 months and after 6 months to assess serum levels of high sensitivity cardiac troponin I (hs-cTnI), Myeloperoxidase (MPO), Interleukin-6 (IL-6) and Alanine aminotransferase (ALT). The study was retrospectively registered in Clinical Trials.gov in April 2022. Its ID is NCT05338723. Compared to control group, Rosuvastatin-treated group had a significantly lower decline in LVEF after 3 months and after 6 months. They had significantly lower Hs-cTnI and IL-6 after 3 months and after 6 months, and significantly lower MPO after 6 months. Four patients in control group experienced cardiotoxicity while no one in rosuvastatin-treated group. Rosuvastatin attenuated cardiotoxicity, so it is a promising protective agent against chemotherapy-induced cardiotoxicity.
摘要:
心脏毒性是接受蒽环类和曲妥珠单抗的人表皮生长因子受体2(HER2)阳性乳腺癌患者化疗的副作用。我们寻找瑞舒伐他汀对化疗诱导的心脏毒性的可能保护作用。方法:将50例新诊断的HER2阳性乳腺癌患者随机分为两组,每组25例。第1组(对照组)接受多柔比星4个周期(3个月),随后接受曲妥珠单抗辅助治疗。第2组(治疗组)接受多柔比星4个周期(3个月),随后在第一个周期化疗前24小时接受曲妥珠单抗辅助治疗和20mg口服瑞舒伐他汀,其余随访期间(6个月)每天一次。经胸超声心动图检查,在开始治疗前24小时收集患者的血液样本,3个月后和6个月后评估血清高敏肌钙蛋白I(hs-cTnI)水平,髓过氧化物酶(MPO),白细胞介素-6(IL-6)和丙氨酸氨基转移酶(ALT)。该研究于2022年4月在ClinicalTrials.gov中进行了回顾性注册。它的ID是NCT05338723。与对照组相比,瑞舒伐他汀治疗组3个月后和6个月后LVEF下降明显较低。3个月后和6个月后,他们的Hs-cTnI和IL-6显着降低,6个月后MPO显著降低。对照组有4例患者出现心脏毒性,而瑞舒伐他汀治疗组无一例。瑞舒伐他汀减轻心脏毒性,因此,它是一种有前途的抗化疗引起的心脏毒性的保护剂。