Naglaa F Gomaa, Rehab H Werida, Ahmed G El-Gowily, Noha A El-Bassiouny
{"title":"Evaluating the role of montelukast on doxorubicin-induced cardiotoxicity in breast cancer patients.","authors":"Naglaa F Gomaa, Rehab H Werida, Ahmed G El-Gowily, Noha A El-Bassiouny","doi":"10.1007/s00520-025-09947-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Doxorubicin (DOX), a prominent anthracycline, is used to treat malignancies, but its cardiotoxicity restricts its therapeutic application. This study examined the potential protective effects of montelukast (ML), an anti-asthmatic drug with anti-inflammatory characteristics, against doxorubicin-induced cardiotoxicity (DIC) in breast cancer (BC) patients.</p><p><strong>Method: </strong>A prospective, randomized, controlled clinical study including fifty individuals with a confirmed diagnosis of BC, individuals scheduled to receive DOX 60 mg/m<sup>2</sup> in conjunction with Cyclophosphamide 600 mg/m<sup>2</sup> (AC) for four courses at 21-day intervals. Both the control group and the ML group were randomly selected from the patient pool.</p><p><strong>Results: </strong>After treatment, a significant reduction in N-terminal Pro Brain Natriuretic Peptide (NT pro-BNP) levels was observed in the ML group compared to the control group (1756.0 [1054.0-2334.0] vs. 3788.0 [2226.0-4401.1] pg/mL, p < 0.001). Nuclear factor-kappa B (NF-κB) levels also decreased significantly in the ML group (2.23 [1.18-3.05] vs. 3.11 [2.39-3.25] pg/mL, p = 0.009). The median percentage reduction in Soluble suppression of tumorigenicity 2 (sST2) levels was more pronounced in the ML group (20.93 ± 5.45 ng/mL) than in the control group (24.16 ± 5.14 ng/mL, p = 0.036). Additionally, a strong positive correlation between NT pro-BNP and NF-κB levels was observed post-treatment (rs = 0.644, p < 0.001), supporting ML's potential anti-inflammatory and cardioprotective effects.</p><p><strong>Conclusion: </strong>The incorporation of ML into AC led to a substantial decrease in cardiac biomarkers confirming the feasibility of incorporating ML in individuals with breast cancer as an auxiliary treatment to prevent DOX-induced cardiotoxicity. Trial registration ClinicalTrials.gov: NCT05959889.</p>","PeriodicalId":22046,"journal":{"name":"Supportive Care in Cancer","volume":"33 10","pages":"897"},"PeriodicalIF":3.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488768/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Supportive Care in Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00520-025-09947-z","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Doxorubicin (DOX), a prominent anthracycline, is used to treat malignancies, but its cardiotoxicity restricts its therapeutic application. This study examined the potential protective effects of montelukast (ML), an anti-asthmatic drug with anti-inflammatory characteristics, against doxorubicin-induced cardiotoxicity (DIC) in breast cancer (BC) patients.
Method: A prospective, randomized, controlled clinical study including fifty individuals with a confirmed diagnosis of BC, individuals scheduled to receive DOX 60 mg/m2 in conjunction with Cyclophosphamide 600 mg/m2 (AC) for four courses at 21-day intervals. Both the control group and the ML group were randomly selected from the patient pool.
Results: After treatment, a significant reduction in N-terminal Pro Brain Natriuretic Peptide (NT pro-BNP) levels was observed in the ML group compared to the control group (1756.0 [1054.0-2334.0] vs. 3788.0 [2226.0-4401.1] pg/mL, p < 0.001). Nuclear factor-kappa B (NF-κB) levels also decreased significantly in the ML group (2.23 [1.18-3.05] vs. 3.11 [2.39-3.25] pg/mL, p = 0.009). The median percentage reduction in Soluble suppression of tumorigenicity 2 (sST2) levels was more pronounced in the ML group (20.93 ± 5.45 ng/mL) than in the control group (24.16 ± 5.14 ng/mL, p = 0.036). Additionally, a strong positive correlation between NT pro-BNP and NF-κB levels was observed post-treatment (rs = 0.644, p < 0.001), supporting ML's potential anti-inflammatory and cardioprotective effects.
Conclusion: The incorporation of ML into AC led to a substantial decrease in cardiac biomarkers confirming the feasibility of incorporating ML in individuals with breast cancer as an auxiliary treatment to prevent DOX-induced cardiotoxicity. Trial registration ClinicalTrials.gov: NCT05959889.
期刊介绍:
Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease.
Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.