Cardiovascular Diseases Clinical Trial
— EMIRAOfficial title:
Early Detection of Imaging-derived Subclinical Cardiac Injuries After Radiotherapy and Chemotherapy for Breast Cancer
NCT number | NCT03575650 |
Other study ID # | 2018-06 |
Secondary ID | |
Status | Recruiting |
Phase | |
First received | |
Last updated | |
Start date | January 24, 2019 |
Est. completion date | September 2, 2024 |
Breast cancer (BC) radiotherapy leads to incidental cardiac irradiation, resulting in an increased risk of various major cardiac events (MCEs). In addition, recent studies indicate that for the treatment of BC, the addition of chemotherapy further enhances the risk of MCEs. Information regarding morphological and functional early subclinical cardiac injuries (ESCIs) induced by chemotherapy and radiotherapy that develop into MCEs is largely lacking in scientific literature. This information is essential towards the development of primary and secondary preventive strategies. The EMIRA prospective cohort has as main objective to identify morphological and functional ESCIs in BC patients treated with adjuvant radiotherapy and chemotherapy.
Status | Recruiting |
Enrollment | 148 |
Est. completion date | September 2, 2024 |
Est. primary completion date | September 2, 2024 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 40 Years to 70 Years |
Eligibility | Inclusion Criteria: 1. Female unilateral BC patients 2. Primary breast conserving surgery or mastectomy for stage I-III invasive adenocarcinoma of the breast or ductal carcinoma in situ (DCIS) 3. Age between 40-70 years at time of chemotherapy/radiotherapy 4. WHO performance status 0-1 5. Planned radiotherapy to the breast/chest wall with or without the lymph node areas 6. Radiotherapy based on planning CT-scan, using either 3D CRT, (partial) IMRT or (partial) VMAT/RapidArc with or without deep inspiration breath-hold 7. Adjuvant systemic chemotherapy (before or after radiotherapy) 8. Written informed consent Exclusion Criteria: 1. Male BC patients 2. M1 disease (metastatic BC) 3. Previous thoracic or mediastinal radiation 4. Neo-adjuvant chemotherapy not allowed 5. Targeted HER2 therapy not allowed 6. Medical history of coronary artery disease and/or myocardial infarction and/or atrial fibrillation 7. Contraindications to injection of iodinated contrast such as allergy or renal failure 8. Pregnancy or lactation 9. Atrial fibrillation detected during electrocardiogram before chemotherapy/radiotherapy 10. Abnormal echocardiography before chemotherapy/radiotherapy defined as: LVEF <50%, longitudinal strain <-16%, longitudinal strain rate <-1%, and/or abnormal wall motion 11. Presence of myocardial infarction detected during cMRI before chemotherapy/radiotherapy 12. cMRI or cCT results before chemotherapy/radiotherapy requiring revascularisation |
Country | Name | City | State |
---|---|---|---|
Netherlands | UMCG | Groningen |
Lead Sponsor | Collaborator |
---|---|
University Medical Center Groningen | Utrecht University |
Netherlands,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Left Ventricle Global Longitudinal Strain (LV-GLS) assessed by echocardiography | Increasement in left ventricle Global Longitudinal Strain (GLS) of at least 5% | 6 and 24 months after radiotherapy with reference to baseline | |
Secondary | Changes in myocardial function assessed by echocardiography | Increasement of segmental strain measurements (unit of measures:%) | 6 and 24 after completion of radiotherapy with reference to baseline | |
Secondary | Anatomical changes in coronary arteries by cardiac CT | Increase in the number of coronary segments containing any plaque/stenosis, or increase in calcium score | 6 and 24 after completion of radiotherapy with reference to baseline | |
Secondary | Myocardial tissue abnormalities assessed by cardiac MRI | Increase of the native mean myocardial T1 mapping value assessed by cardiac MRI | 6 and 24 after completion of radiotherapy with reference to baseline |
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