Avaliação de micropartículas, marcadores hemostáticos e cardiovasculares em pacientes com câncer de mama submetidas à quimioterapia por doxorrubicina

Abstract

Breast cancer is the most prevalent cancer in women and is the second leading cause of cancer death in women. Doxorubicin (DOXO) is an anthrcycline used in breast cancer treatment. It has a adverse effects that can implicate treatment and descrease the life quality of patients. The most common adverse effect is cardiotoxicity. The main aim of this study is the evaluation of hemostatic biomarkers (like thrombin generation test), cardiovascular biomarkers and microparticles in breast cancer patients under DOXO chemotherapy, with or not cardiotoxicity secondary to anti-cancer treatment. The leading study design included 80 women with breast carcinoma and with indication for DOXO chemotherapy. The patients were followed prospectively at three times, before chemotherapy (T0), after chemotherapy (T1) and 12 months after chemotherapy (T2). The mean age was 50.3 ± 12.7 years. The median dose of DOXO administered was 380 mg/m2 and the rate of cardiotoxicity was 33.75%, 7 deaths had occurred. The prevalent histological type was invasive ductal carcinoma (90%). In the prospective study, patients with cardiotoxicity had a higher thrombin peak (at T0), higher count of total microparticles (T0), microparticles derived from cardiomyocytes (T0 and T1), microparticles derived from endothelium (T0 and T1) and microparticles that express tissue factor (T0 ). In a secondary approach (case-control study), serum levels of GDF-15 were higher in breast cancer patients compared to healthy subjects. The data suggest that DOXO treatment can change hemostatic parameters, cardiac function, cardiovascular markers and induce the release of microparticles in patients who use it in the chemotherapy treatment of breast cancer.