ArticleFrontiers in oncology2026
Galectin-9, FABP4 and pentraxin-3 are associated with myocardial dysfunction and discriminate chemotherapy-related cardiac dysfunction in anthracycline-treated breast cancer: a single-centre retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Anthracycline-based chemotherapy improves breast cancer outcomes but may cause cancer therapy-related cardiac dysfunction (CTRCD). Biomarkers reflecting inflammatory and metabolic myocardial stress may complement imaging surveillance, but the combined value of galectin-9 (Gal-9), fatty-acid-binding protein 4 (FABP4) and pentraxin-3 (PTX-3) is unclear. Objective: This study aimed to evaluate whether serum Gal-9, FABP4 and PTX-3 are associated with myocardial dysfunction and discriminate CTRCD. Methods: This single-centre retrospective cohort included 219 women receiving at least three anthracycline-based cycles from December 2022 to June 2025. Patients were classified as CTRCD (n = 66) or non-CTRCD (n = 153) using ASE/EACVI and ESC criteria. Baseline and post-cycle-3 echocardiography and hs-cTnI were recorded; post-cycle-3 biomarkers were measured by ELISA. Analyses included adjusted correlations, multivariable logistic regression, ROC/DeLong testing and bootstrap validation. Results: Baseline characteristics were comparable. After chemotherapy, Gal-9, FABP4 and PTX-3 were higher, whereas LVEF, |GLS| and MCI were lower, in the CTRCD group (all P < 0.05). Biomarkers correlated inversely with LVEF, |GLS| and MCI after adjustment (all P < 0.001). The combined biomarker score was independently associated with CTRCD (adjusted OR 3.25 per SD; 95% CI 2.09-5.07; P < 0.001). The combined model achieved an AUC of 0.880 (95% CI 0.829-0.920), optimism-corrected AUC of 0.854 and cross-validated AUC of 0.846, improving the clinical-model AUC from 0.642 to 0.872 (P < 0.001). Conclusion: Gal-9, FABP4 and PTX-3 were associated with concurrent myocardial dysfunction and improved discrimination of on-treatment CTRCD. This candidate adjunctive panel requires serial sampling and external validation before clinical use.
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