Multi-modality
cancer treatments that include
chemotherapy,
radiation therapy, and targeted agents are highly effective
therapies. Their use, especially in combination, is limited by the risk of significant
cardiac toxicity. The current paradigm for minimizing cardiac morbidity, based on serial cardiac function monitoring, is suboptimal. An alternative approach based on
biomarker testing, has emerged as a promising adjunct and a potential substitute to routine echocardiography.
Biomarkers, most prominently cardiac
troponins and
natriuretic peptides, have been evaluated for their ability to describe the risk of potential cardiac dysfunction in clinically asymptomatic patients. Early rises in cardiac
troponin concentrations have consistently predicted the risk and severity of significant
cardiac events in patients treated with
anthracycline-based
chemotherapy.
Biomarkers represent a novel, efficient, and robust clinical decision tool for the management of
cancer therapy-induced
cardiotoxicity. This article aims to review the clinical evidence that supports the use of established
biomarkers such as cardiac
troponins and
natriuretic peptides, as well as emerging data on proposed
biomarkers.