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Soluble suppression of tumorigenicity-2 changes during cardiotoxic cancer treatment: a systematic review and meta-analysis

Year: 2025
Type: review
Abstract: Background Soluble suppression of tumorigenicity-2 (sST2) is a promising biomarker of cardiovascular disease and heart failure. Data about the changes in sST2 concentrations during cancer treatment and the relationship with cancer treatment-related cardiotoxicity are sparse. Methods We conducted a systematic review and meta-analysis to explore longitudinal changes in sST2 levels at three time points (T0 baseline, T1 post-chemotherapy, and T2 follow-up) in cancer patients treated with cardiotoxic therapies and compared these changes to traditional biomarkers of cardiac injury, i.e., troponin and NT-proBNP. Using random-effects models, mean differences (MD), and standardized MD (SMD), we analyzed (i) ST2 longitudinal changes, (ii) the association between ST2 and cardiotoxicity [defined through left ventricular ejection fraction (LVEF)] providing pooled estimates of correlations, and (iii) the SMD variations among biomarkers. Results Eight studies were included, comprising 433 patients treated with anthracycline and/or HER2-directed antibodies. There was a trend toward increased sST2 levels from T0 to T2 (MD 1.86, 95% CI −0.97 to 4.68, p = 0.200) and decreased levels from T1 to T2 (MD −1.96, 95% CI −4.28 to 0.37, p = 0.100). A pooled analysis showed a negative correlation between sST2 levels and LVEF (r −0.29, 95% CI, −0.49- −0.05, p < 0.010). Comparisons with Troponin and NT-proBNP showed a significantly higher Troponin SMD at T0-T1 ( p = 0.027), while no significant differences were observed for NT-proBNP. Conclusion sST2 showed dynamic changes during cardiotoxic therapy correlating with cardiotoxicity. Troponin was demonstrated to have greater longitudinal variations. Further research is needed to evaluate longitudinal sST2 levels in patients who develop cardiotoxicity vs. those who do not.
DOI: 10.3389/fcvm.2025.1624023
Authors: Luca Fazzini, Simone Angius, Nicola Campana, Luca Pascalis, Martino Deidda, Giordano Maria Pugliesi, Vincenzo Quagliariello, Nicola Maurea, Carlo Gabriele Tocchetti, Pietro Ameri, Christian Cadeddu Dessalvi
Institutions: University of Cagliari, Mayo Clinic, University of Milano-Bicocca, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Federico II University Hospital, University of Naples Federico II, Ospedale Policlinico San Martino, University of Genoa
Language: English
Field: Medicine
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4416128243
FWCI: 0.597
Cites: 38
Cited by: 2
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