Prognostication of Early Cardio toxicity in Anti-Neoplastic Chemotherapy: The Role of Biological Markers

Cardiotoxicity due to tumoricidal drug use is defined as an asymptomatic reduction in Left Ventricular (LV) Ejection Fraction (EF) of ≥10% to <55% or as a reduction of the LVEF of ≥5% to <55% with symptoms of Heart Failure (HF). The implementation in routine practices the highly tumoricidal anthracycline drugs, taxanes, and trastuzumab cause progressive LV dysfunction and symptomatic HF in dose-dependent manner. Despite there is potent reversibility of tumoricidal drug-induced cardiotoxicity, this adverse effect frequently consists continuously and might lead to limited response to medical treatment and worse survival sufficiently. The aim of the mini review is consideration the clinical evidence that supports the use of cardiac biomarkers for early detection of cardiotoxicity. The review is reported that the identification of cancer patient with increased risk of early cardiotoxicity would allow not only prevention and diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. The predictive role of brain natriuretic peptides, cardiac troponins and inflammatory biomarkers (C-reactive protein) is discussed.