Effects of Carvedilol on Cardiotoxicity in Cancer Patients Submitted to Anthracycline Therapy

  • STATUS
    Recruiting
  • End date
    Dec 30, 2024
  • participants needed
    1018
  • sponsor
    Hospital Sirio-Libanes
Updated on 8 October 2021
treatment regimen
anthracyclines
primary cancer

Summary

Neoplasia is the main cause of general death in the Brazilian population. In 2016, they were responsible for approximately 211,343 (16%) deaths, followed by cardiovascular diseases (12.6%). Despite the high mortality rate of neoplasia, oncological treatment have advanced substantially in recent decades improving the prognosis of patients. However, growing evidence suggest that some oncological agents may induce significant toxicity that may play a major role in the quality of life, morbidity and mortality. The cardiovascular system is often negatively affected with cancer therapy, predisposing several patients to stop appropriate treatments or to have cardiovascular events related to the cardiotoxicity. The most typical manifestation of cardiotoxicity and related consequences (heart failure) are related to the use of anthracyclines. Anthracyclines are part of the chemotherapy regimen for solid tumors and hematological neoplasms in children and adults, and are associated with an increase in life expectancy. Carvedilol is an and -blocker that also has antioxidant properties. Preliminary studies have shown that carvedilol and its metabolites prevent lipid peroxidation, inhibit the formation and inactivate free radicals, in addition to preventing the depletion of endogenous antioxidants, such as vitamin E. These effects would potentially prevent anthracycline injury but definitive evidence is still needed. This is a multi-center, double-blind, randomized, placebo-controlled study that aims to establish the efficacy of carvedilol for the primary prevention of left ventricular systolic dysfunction in cancer patients obtained with anthracycline chemotherapy, in different schedules and doses.

Details
Condition primary malignant neoplasm, Cancer, Neoplasms, malignancy, malignancies, cancers, malignant tumor, primary cancer, Cancer/Tumors, Ewing's Family Tumors, malignant tumors, Cancer (Pediatric)
Treatment Placebo, Carvedilol
Clinical Study IdentifierNCT04939883
SponsorHospital Sirio-Libanes
Last Modified on8 October 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

years of age at the time of screening
Cancer patients that will receive chemotherapy with anthracyclines

Exclusion Criteria

Inability to adequate asses left ventricular function
Previous history of heart failure
Previous history of any cardiomyopathy (eg.: valve disease, Chagas' disease, infiltrative cardiomyopathy)
LVEF < 50%
Previous history of myocardial revascularization
Permanent tachyarrhythmia (flutter, atrial fibrillation, atrial tachycardia)
Contra-indication to the use of beta-blockers
Trastuzumab indication
Pregnant or Breast-feeding females
On kidney replacement therapy
ECOG >= 4 or Karnofsky <=30
Advanced hepatic failure (C score Child-Pugh and MELD > 15)
Previous use of anthracycline
Have any serious concomitant systemic disease, condition, or disorder that, in the opinion of the investigator, should preclude participation in this study
Are concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study
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