Dakota Gustafson, Priya Mistry, Crizza Ching, Inbar Nardi-Agmon, Christopher Yu, Chun-Po Steve Fan, Christian Houbois, Eitan Amir, Thomas Marwick, Husam Abdel-Qadir, Chris McIntosh, Paaladinesh Thavendiranathan, Jason E. Fish
BACKGROUND: Blood biomarkers to predict cancer therapy-related cardiac dysfunction (CTRCD) risk remain limited. OBJECTIVES: breast cancer patients. METHODS: breast cancer receiving anthracycline and trastuzumab therapy underwent serial evaluation with cardiac magnetic resonance imaging (CMR), echocardiography, clinical assessments, and blood biobanking every 3 months. Multiomics profiling of 3 circulating cardiac damage biomarkers and 35 markers of inflammation, angiogenesis and endothelial activation and profiling of >2,000 plasma microRNAs were performed before and early during treatment (3 and 6 months). CTRCD was defined by left ventricular ejection fraction measured on CMR, and sensitivity analyses used echocardiography. Pretreatment protein biomarkers were measured in a validation cohort. RESULTS: breast cancer patients. CONCLUSIONS: Pretreatment endothelial-centric and inflammatory biomarkers outperformed both clinical and CMR measures in predicting CTRCD during chemotherapy.