Cardiac risk and oxidative stress evaluation in trastuzumab treated HER-2 positive breast cancer patients

The present study was designed to investigate the relation between the action of Trastuzumab treatment and alteration of some important biochemical, cardiac markers and hematological variables in HER-2 positive breast cancer patients. Forty-four adult patients with HER-2 positive breast cancer at Nanakaly hospital-Erbil (Specialized hospital for Oncology and Hematology diseases) were included in this study. The collection sample was performed within (9) months from 1 March to 1 November 2016. Their body mass indexes were ranged between 16.41-43.76 matches (45-80) years and their weights were ranged between (65-105). The whole history was obtained from all patients using prepared questionnaire form, and a standardized case-control study of breast cancer was established through taking 20 control patients (Her-2 positive cancer patients without treatment). The patients were categorized according to a number of major variables including Grades, Body mass index, Dose, and duration of trastuzumab treatment. After collection of blood samples, the hematological analysis was performed directly using Hemolyzer 5'Analyzer. The evaluation of biochemical tests, oxidative stress markers, and cardiac markers were made using sera of the patients and controls using Cobas e411 and c311. The biochemical parameters included: Lipid profile, Blood glucose, while the cardiac marker included cardiac troponin and CKMB enzyme. While the oxidative stress markers were serum MDA and serum nitrite. The analyses of results were divided into three main categories: The comparison between controls and patients and the comparison between the different Grades performed using a t-test, while comparison of different BMI performed using ANOVA test. The comparison between the control and patients showed that the significant differences were found in cardiac troponin, MDA, nitrite and platelet's parameters. While the non-significant differences were recorded between them in IL-1-R1and other estimated variables. Moreover, the comparison between the grades reported a significant difference between the Grades II and III regarding IL1-R1 and cardiac markers. The results of comparison for the dose and duration of treatment showed significant differences in case of Troponin, MDA, hemoglobin and platelet count. While the rest of parameters were non-significant. Among the important findings which were recorded, the significant reduction of cardiac Troponin level with increasing the dose and duration. Regarding the impact of obesity on the cardiotoxicity of trastuzumab, the results showed no obvious relation between an elevation of BMI with almost all variables related to cardiac toxicity, except in case of nitrite and mean platelet volume. Key words: Breast cancer, Trastuzumab, Toxicity, Hert-2 positive.