Publication | August 25, 2026
Cardiac remodelling and dysfunction in cancer patients receiving cardiotoxic therapies: proteomic and metabolomic profiling
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Read the PaperSapient provided deep metabolomics profiling for this multi-omics study for cardiotoxicity biomarkers analysis – led by a large industry-academia collaborative and published in European Heart Journal – which uncovered new biomarkers of cancer therapy-related cardiac dysfunction and remodelling.
Breast cancer patients often receive potentially cardiotoxic therapies including anthracyclines, radiation, and hormone therapies, yet there is still a limited understanding of the underlying biologic perturbations that occur with cancer therapy-related cardiotoxicity. Current biomarkers largely lack the sensitivity and specificity to accurately diagnose such cardiac injury and are not predictive of cardiac dysfunction.
In this large-scale industry-academia collaborative study, recently published in European Heart Journal, researchers set out to discover new circulating biomarkers that can provide insights into the pathophysiologic changes in cardiac structure, function, and remodelling that occur following cancer therapy. Proteomics and metabolomics profiling was performed in a longitudinal cohort study of more than 500 breast cancer patients receiving cardiotoxic therapies (anthracyclines and/or trastuzumab). Multivariable linear mixed-effect models were then applied for cardiotoxicity biomarkers analysis, evaluating associations between repeated measures of individual proteins or metabolites with quantitative echocardiographic measures of cardiac structure and function over multiple patient visits.
Metabolomics analysis utilized Sapient’s rapid liquid chromatography-mass spectrometry (rLC-MS) platform to assay tens of thousands of metabolites per sample, revealing 16 unique metabolites significantly associated with measures of cardiac structure and function, including five – n-acetylglutamine, aspartic acid, acetylasparagine, alanyl-alanine, and prolyl-glycine – which overlapped between left ventricular ejection fraction (LVEF) and longitudinal strain.
The proteomics analysis used the Olink Explore 3072 platform and found 203 unique proteins with significant associations to cardiac structure and function measures, most notably cathepsin C (CTSC) with the strongest association with longitudinal strain. These findings reveal that there are significant associations between circulating metabolomic and proteomic markers and echocardiographic measures in breast cancer patients receiving cardiotoxic cancer therapy – associations that could only be uncovered through broad, comprehensive multi-omics analysis.
The study provides important new biological insight into the role that key pathways play in cancer therapy-related cardiac dysfunction and remodelling, reveals potentially novel markers for the diagnosis and prediction of cancer therapy-related cardiac dysfunction, and demonstrates how large-scale, multi-omics cardiotoxicity biomarkers analysis can uncover more sensitive and specific circulating markers that may improve risk prediction.
To learn more, read the full paper and findings.