Abstract Number: PB1128
Meeting: ISTH 2021 Congress
Background: Anthracyclines, especially doxorubicin (DOXO), are widely used in the treatment of patients with breast cancer. However, secondary cardiotoxicity is a limiting outcome to its use. Cancer patients commonly present hemostatic abnormalities correlating with the worsening of the disease. Thrombin Generation Test (TGT) may be a useful tool for detecting such abnormalities in patients with breast cancer using DOXO, particularly those who develop cardiotoxicity.
Aims: To evaluate the performance of TGT in patients with breast cancer before and after treatment with DOXO, with or without treatment-related cardiotoxicity.
Methods: Blood samples were collected from 80 women with breast cancer at different times, before (T0), shortly after (T1) and one year after the use of DOXO (T2) (median dose was 380 mg/m2). Invasive carcinoma was observed in 72 participants (90.0%) followed by other less frequent types. TGT was performed using the CAT method. The study received approval from the local Ethics Committee and is in accordance with the Declaration of Helsinsk.
Results: Of the total participants, 27 (33.75%) had cardiotoxicity, while 53 (66.25%) did not. Only at T0, an increased value for the Peak was observed in those who developed cardiotoxicity (p=0.030), suggesting that hypercoagulability, a priori, may predispose to this complication. However, the use of DOXO increased Peak and Endogenous Thrombin Potential (ETP) values in relation to their baseline levels (T0 x T1 and T0 x T2; p <0.001 for both), only in those who did not develop cardiotoxicity, that is, in those who were less hypercoagulable in T0.
Conclusions: This finding suggests that the use of DOXO increases the hypercoagulable status. Moreover, evaluation by TGT before treatment with DOXO may be a useful predictor of cardiotoxicity in women with breast cancer who will be treated with this drug.
To cite this abstract in AMA style:Pestana RMC, Duarte RCF, Sabino AdP, Silva LM, Simões R, Gomes KB, Carvalho MdG. Breast Cancer, Doxorubicin and Cardiotoxicity: Can Thrombin Generation Test Be Useful? [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/breast-cancer-doxorubicin-and-cardiotoxicity-can-thrombin-generation-test-be-useful/. Accessed December 7, 2021.
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