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Assessment of Cardiotoxicity by Cardiac MRI Versus MUGA Scans in Breast Cancer Patients Receiving Trastuzumab: A Double-Blinded Prospective Observational Pilot Study


N/A
18 Years
N/A
Open (Enrolling)
Both
Stage I-IV Breast Cancer (Neo-adjuvant, Adjuvant, Locally Advanced and Metastatic)

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Trial Information

Assessment of Cardiotoxicity by Cardiac MRI Versus MUGA Scans in Breast Cancer Patients Receiving Trastuzumab: A Double-Blinded Prospective Observational Pilot Study


Currently, serial MUGA scans are the imaging modality of choice for monitoring
cardiotoxicity. However, MUGA scans only measure LVEF at the cost of ionizing radiation and
considerable inter-study variability, and do not reliably detect cardiomyopathy. CMR is a
highly accurate technique and represents a promising imaging alternative. Because CMR is now
considered the gold standard for measuring LVEF and subclinical alterations in cardiac
structure and function, it will be used in this prospective observational pilot study to
determine its effectiveness for monitoring cardiotoxicity in patients receiving trastuzumab.
Serial CMR will be compared to serial MUGA scans, as they are routinely used for LVEF
monitoring with trastuzumab therapy, in standard practice. Cardiac biomarkers will also be
measured in relation to CMR and MUGA scans. Furthermore, we will determine the long-term
clinical and prognostic implications of trastuzumab-induced cardiotoxicity detected by these
various methods.

This will be a double-blinded prospective observational pilot study of breast cancer
patients with overexpression of HER2 on breast pathology (using either immunohistochemistry
[IHC] and/or fluorescence in-situ hybridization [FISH]), who have never received trastuzumab
before, who will be treated with trastuzumab.


Inclusion Criteria:



- Aged 18 years or older

- Eastern Cooperative Oncology Group (ECOG) performance status 0-2

- Histologically confirmed diagnosis of invasive breast carcinoma

- Histologically confirmed HER2 overexpression using IHC and/or FISH and/or DISH

- Planned treatment with Trastuzumab or TDM-1

- Baseline LVEF >50% by MUGA (ECHOs or any other type of cardiac scanning may be done
as part of standard clinical care, at the investigator's discretion; ECHOs cannot be
done in place of MUGA scans)

Exclusion criteria:

- Previous treatment with trastuzumab or any other anti-HER2 agent (e.g. lapatinib,
pertuzumab, etc.)

- Pre-existing symptomatic Heart Failure (NYHA Class III or IV)

- Recent acute coronary syndrome (myocardial infarction, unstable angina) within the
last six months

- Recent coronary revascularization (percutaneous coronary intervention or coronary
bypass surgery) within six months

- Permanent atrial fibrillation

- Inability to undergo MRI (shrapnel, metallic implants/clips, pacemaker or
defibrillator)

- Currently pregnant and/or nursing

- Planned or current use of other targeted biological therapies that can potentially
cause cardiotoxicity (i.e. bevacizumab)

Type of Study:

Observational

Study Design:

Time Perspective: Prospective

Outcome Measure:

To compare CMR with MUGA scans for determining LVEF and LV volumes in breast cancer patients treated with trastuzumab.

Outcome Time Frame:

five years

Safety Issue:

No

Authority:

Canada: Canadian Institutes of Health Research

Study ID:

Cardiac CMR

NCT ID:

NCT01022086

Start Date:

November 2009

Completion Date:

February 2017

Related Keywords:

  • Stage I-IV Breast Cancer (Neo-adjuvant, Adjuvant, Locally Advanced and Metastatic)
  • Breast Cancer
  • Cardiotoxicity
  • Trastuzumab
  • Cardiac MRI
  • Breast Neoplasms

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