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Macrophage Migration Inhibitory Factor / Chemotherapy-induced Cardiotoxicity and Mitigation / GDF15 and Related Biomarkers · Journal article
Indian Journal of Physiology and Pharmacology · August 10, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a small single-centre exploratory cohort study of novel cardiac biomarkers in 37 breast cancer patients undergoing neoadjuvant chemotherapy. GPBB, hscTnI, and CA 19-9 increased significantly after treatment and LVEF declined, but novel biomarkers (CCL23, MIF, MPO) showed no significant change or correlation with LVEF or CTRCD status, and the authors conclude they lack clinically significant additional utility for assessing cardiotoxicity.
Single-centre observational cohort study. Postmenopausal women newly diagnosed with locally advanced breast cancer, recruited at a single centre.. Intervention: 7 cycles of neoadjuvant chemotherapy (NACT) for breast cancer.. n = 37. Not stated in source..
GPBB, hscTnI and CA 19-9 showed significant increase from baseline after NACT Significant reduction in LVEF after NACT Significant inverse correlation between LVEF and hscTnI (r = −0.58, p < 0.001)
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The findings do not support routine clinical use of GPBB, CCL23, MIF, or MPO for detecting cancer therapy-related cardiac dysfunction in breast cancer patients. Conventional markers (hscTnI and LVEF) remain the indicators; validation in larger cohorts is needed before any biomarker can be recommended for clinical practice.
Small single-centre uncontrolled study of novel biomarkers in breast cancer patients; exploratory design with negative primary findings for most novel markers, requiring larger validation studies.
As stated by the source record.
Quoted from the source exactly as published.
The findings do not support routine clinical use of GPBB, CCL23, MIF, or MPO for detecting cancer therapy-related cardiac dysfunction in breast cancer patients. Conventional markers (hscTnI and LVEF) remain the indicators; validation in larger cohorts is needed before any biomarker can be recommended for clinical practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Objectives: Cancer therapy-related cardiac dysfunction (CTRCD), defined based on changes in left ventricular ejection fraction (LVEF) and cardiac biomarker levels, is a significant complication of chemotherapy, often subclinical in early stages. While conventional markers (high sensitivity cardio troponin I [hscTnI], N-terminal pro-brain natriuretic peptide) are routinely used, the role of novel biomarkers (glycogen phosphorylase BB [GPBB]), myeloperoxidase (MPO), chemokine ligand-23 (CCL23) and macrophage migration inhibitory factor (MIF) remains unknown. Furthermore, the potential influence of shared cancer and cardiovascular disease on tumour marker variability remains unclear, as they share common risk factors and biological pathways. This study aimed to evaluate selected biomarkers alongside hscTnI and LVEF in breast cancer patients undergoing neoadjuvant chemotherapy (NACT). Materials and Methods: Postmenopausal women ( n = 37) newly diagnosed with locally advanced breast cancer were recruited. Biomarkers were measured using a Beckman Coulter chemiluminescence analyser (Dxi600) and enzyme-linked immunosorbent assay before and after 7 cycles of NACT. The Statistical Package for the Social Sciences software version 20.0 was used for analysing the data. Results: GPBB, hscTnI and cancer antigen 19-9 (CA 19-9) showed a significant increase from baseline after NACT, with a significant reduction in LVEF. No significant differences were observed in CCL23 (Myeloid Progenitor Inhibitor Factor-1), MIF, MPO, CA 125, carcinoembryonic antigen, CA 15-3 and cytokeratin fragment antigen 21-1 before and after NACT. A significant inverse correlation emerged between LVEF and hscTnI levels (r = −0.58, p < 0.001). No significant correlations were seen between LVEF and other biomarkers. Thirty per cent of breast cancer patients developed mild, asymptomatic CTRCD after NACT. The levels of LVEF and hscTnI among patients with and without CTRCD after NACT differed significantly. However, levels of other biomarkers did not differ significantly between the two patient groups. Conclusion: The evaluated novel biomarkers did not demonstrate clinically significant additional utility for assessing cancer therapy-related cardiotoxicity in our cohort. However, these findings are exploratory and require validation in larger studies.
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