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The following is a summary of “Effects of taxane-anthracycline and taxane only treatment on cardiac function in breast cancer—a retrospective cohort study,” published in the April 2025 issue of Cardio-Oncology by Kézdi et al. 

This retrospective study assessed the longitudinal impact of anthracycline plus taxane combination therapy versus single-agent taxane chemotherapy on cardiac function in women undergoing treatment for breast cancer. Given the established cardiotoxic potential of anthracyclines, particularly in combination regimens, researchers aimed to determine whether clinically significant echocardiographic changes occur in routine clinical practice.

Study group reviewed clinical and echocardiographic data from 68 women aged over 18 years who received chemotherapy for breast cancer between 2018 and 2021 at the Cardiology Outpatient Clinic of Semmelweis University, Department of Internal Medicine and Oncology. Baseline cardiovascular history was documented, and serial transthoracic echocardiograms were performed throughout treatment and follow-up. Patients were categorized into two groups based on chemotherapy regimen: anthracycline plus taxane, and single-agent taxane. Echocardiographic data were analyzed across five time intervals: within 0–14 days of treatment initiation, and then every six months up to beyond 545 days. The trajectory of key cardiac parameters, including left ventricular ejection fraction and markers of diastolic function such as deceleration time, was evaluated using linear mixed-effects modeling.

The mean age of participants was 52.7 ± 14.1 years in the anthracycline-taxane group and 55.2 ± 13.1 years in the single taxane group. The mean cumulative anthracycline exposure was equivalent to 240 mg/m² of doxorubicin. At baseline, cardiovascular comorbidity burden was minimal across both cohorts. In the anthracycline plus taxane group, LVEF showed a modest yet statistically significant decline from 65.5 ± 3.1% at baseline to 62.1 ± 3.2% at 181–365 days (p = 0.007), followed by recovery to near-baseline levels in subsequent follow-ups (p = NS). Similarly, DT decreased from 227.9 ± 33.9 ms to 197.4 ± 29.4 ms at 15–180 days (p = 0.028), but normalized over time. These alterations were transient and clinically insignificant. No significant echocardiographic changes were observed in the single-agent taxane group. Additional analyses identified age and hypertension as independent modifiers of LVEF decline.

Anthracycline-taxane combination chemotherapy is associated with mild, reversible changes in cardiac function, while single-agent taxane therapy appears to have a negligible cardiac impact. These findings support the cardiac safety of these regimens over a 1.5-year follow-up period in patients without significant pre-existing cardiovascular disease. However, the study’s retrospective design and limited sample size necessitate cautious interpretation and underscore the need for prospective studies to confirm these observations.

Source: cardiooncologyjournal.biomedcentral.com/articles/10.1186/s40959-025-00335-4