The Relationship Between Blood Lipidomics and Cardiotoxic Injury Following Acute Exposure to Anthracycline Chemotherapy in Women With Breast Cancer: A Feasibility Study.

BACKGROUND

Anthracycline chemotherapy (AC) leads to cardiotoxicity in many patients with breast cancer by inducing inner mitochondrial damage and disrupting the electron transport chain. It is unclear why some, but not all, women who undergo AC develop chronic cardiac dysfunction.

OBJECTIVES

The aim of this prospective feasibility study was to determine accrual rate and estimate the effect size of 1 cycle of AC on myocardial injury and blood lipidome changes in women with breast cancer.

METHODS

Fourteen women with breast cancer planning to undergo AC enrolled and underwent cardiac magnetic resonance (CMR) imaging and blood sampling across 2 visits, before and after any 1 cycle of AC in the treatment regimen. Fatty acid composition of red blood cells (RBCs) and cardiolipin (CL) in peripheral blood mononuclear cells were measured. Exploratory analyses were conducted.

RESULTS

Myocardial edema, obtained via T2 mapping using CMR, increased after 1 cycle of AC in women with breast cancer. The ratio of tetralinoleoyl (LA4) to tetraoleoyl (OA4) CL correlated negatively with myocardial fibrosis, obtained via T1 mapping using CMR. OA4CL correlated positively with myocardial fibrosis, and OA content in RBCs correlated positively with myocardial edema.

CONCLUSIONS

OA4CL and OA in RBCs appear to be related to subclinical markers of cardiotoxicity in women with breast cancer undergoing AC. Larger studies are needed to investigate potential cardioprotective effects of dietary linoleic acid and LA4CL against AC.This trial was registered at clinicaltrials.gov as NCT03961685.