Cardioprotective Effect of Pegfilgrastim on Chemotherapy-induced Cardiotoxicity in Preoperative Chemotherapy for Breast Cancer

Background/Aim: Chemotherapy for breast cancer, particularly with anthracyclines and trastuzumab, is known to induce cardiotoxicity. Pegfilgrastim, a granulocyte colony-stimulating factor analog used to prevent chemotherapy-induced neutropenia, has shown potential myocardial protective effects. This study investigated pegfilgrastim’s effect on preoperative chemotherapy-induced cardiotoxicity.

Patients and Methods: We retrospectively reviewed 110 patients who underwent preoperative chemotherapy from 2010 to 2019 and whose cardiac function was evaluated before and after chemotherapy. All patients received either Adriamycin or Fluorouracil, Epirubicin, and Cyclophosphamide as anthracyclines; in HER2-positive breast cancer, taxanes were combined with anti-HER2 therapy. Cardiac function was evaluated by ultrasound before and after chemotherapy.

Results: Sixty-one patients treated with pegfilgrastim were compared to 49 non-treated patients. Cardiac function did not change with chemotherapy in the pegfilgrastim group; however, the ejection fraction with chemotherapy in the non-pegfilgrastim group decreased significantly (p=0.027).

Conclusion: Pegfilgrastim may reduce chemotherapy-induced cardiotoxicity in addition to preventing febrile neutropenia.