Stress Echocardiography to Identify Chemotherapy Induced Cardiotoxicity in Cancer Patients With Heart Failure Risk

Phase

N/A

Condition

Neoplasms

Congestive Heart Failure

Heart Failure

Treatment

Echocardiography

Electronic Health Record Review

Stress Echocardiography

Clinical Study ID

NCT05950399

15-002855

NCI-2022-10806

15-002855

Ages > 18
All Genders
Accepts Healthy Volunteers

Study Summary

This clinical trial evaluates changes in cardiac (heart) function during stress echocardiography to screen for chemically induced cardiotoxicity in cancer patients at a high risk for developing heart failure. Some chemotherapeutic agents to treat certain types of cancers can induce cardiac dysfunction and heart failure. Currently there is no validated means of predicting which patients will go on to develop cardiac toxicity and heart failure following treatment with chemotherapeutic agents. Stress echocardiography is a test that uses ultrasound imaging to show how well the heart muscle is working to pump blood to the body during low intensity exercise. Stress echocardiography prior to and during cancer treatment may help doctors find cancer therapeutic related cardiac dysfunction sooner when it may be easier to treat.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Current or previous diagnosis of solid organ cancers (breast, non-small cell lung,rectal, renal, hepatic cancer, metastatic melanoma, sarcoma) or hematological disease (lymphoma, leukemia, multiple myeloma, monoclonal gammopathy of undeterminedsignificance [MGUS])
Age >= 18 years at study enrollment
Plan to receive, or history of having received, chemotherapy (anthracycline,alkylating agent [cyclophosphamide, ifosfamide], and/or antimicrotubule agent [docetaxel, paclitaxel]) with or without specific targeted therapies;
Anti-HER2 targeted therapies (trastuzumab, pertuzumab)
Vascular endothelial growth factor (VEGF) inhibitors (bevacizumab, sunitinib,sorafenib, pazopanib, axitinib, vandetanib)
Immune checkpoint inhibitors (ipilimumab, nivolumab, pembrolizumab)
Plan to undergo conditioning chemotherapy for bone marrow transplantation (autologous/allogeneic)

Exclusion

Exclusion Criteria:

Coronary artery disease
Significant (more than mild) valvular heart disease
Pre-existing heart failure
Pre-existing cardiomyopathy
Musculoskeletal or neurologic abnormality prohibiting low intensity exercise on astationary bicycle
Severe pulmonary disease limiting ability to perform low intensity exercise on astationary bicycle

Study Design

Echocardiography

June 29, 2015

March 19, 2024

Study Description

PRIMARY OBJECTIVES:

I. To determine whether changes in the following parameters of cardiac function at rest or with low intensity exercise occur following (1) treatment with cancer therapeutics or (2) cardiac rehabilitation:

Ia. 2-Dimensional (2D) and 3-dimensional (3D) left ventricular (LV) longitudinal strain and strain rate; Ib. Right ventricular (RV) longitudinal strain and strain rate; Ic. LV circumferential and radial strain and strain rate; Id. 2D and 3D wall motion; Ie. 2D and 3D volumetric left ventricular ejection fraction (LVEF); If. Mitral valve inflow velocities (E, A) and mitral annular tissue Doppler (e', a'); Ig. Tricuspid tissue velocities and tricuspid annular plane systolic excursion (TAPSE).

SECONDARY OBJECTIVES:

I. To determine whether changes after treatment with cancer therapeutics or a period of cardiac rehabilitation in any of the aforementioned parameters of cardiac function with low intensity exercise:

Ia. Occur before changes in resting strain or resting LVEF; Ib. Predict future reductions in LVEF (cardiotoxicity) or in the case of cardiac rehabilitation, prevention of LVEF decrease; Ic. Predict the development of clinical heart failure.

OUTLINE: Participants are assigned to 1 of 2 groups.

GROUP I (CASE): Patients choose to undergo either a resting echocardiography performed before and after delivery of a cancer therapeutic agent and months 3, 6, 9 and 12 or up to 5 low intensity stress echocardiography over 25 minutes performed depending on where they are at in the course of their cancer therapy and/or cardiac rehabilitation program at baseline and/or months 3, 6, 9 and 12 after starting cancer therapy.

GROUP II (CONTROL): Participants undergo low intensity stress echocardiography over 25 minutes at baseline and may undergo a second one at least 24 hours later.

After completion of study intervention, patients in Group 1 are followed up at 2, 5, and 10 years.

Connect with a study center

Mayo Clinic in Rochester
Rochester, Minnesota 55905
United States
Site Not Available

Not the study for you?

Let us help you find the best match. Sign up as a volunteer and receive email notifications when clinical trials are posted in the medical category of interest to you.