Breast Cancer Long-term Outcomes on Cardiac Functioning: a Longitudinal Study

NCT05851053 — Recruiting, 455 participants, University Medical Center Groningen

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RegistryNCT05851053, acronym BLOC-II
StatusRecruiting
Study typeObservational
Enrollment455 (Estimated)
SponsorUniversity Medical Center Groningen (Other); collaborators: ZonMw: The Netherlands Organisation for Health Research and Development
ConditionsNeoplasm, Breast, Heart Failure, Cardiotoxicity, Ventricular Dysfunction
InterventionsEchocardiography (Diagnostic test)
Datesstart 2022-09-01, primary completion 2025-12-31 (estimated), completion 2026-12-31 (estimated), first posted 2023-05-09, last updated 2024-05-29
Locations1 site in Netherlands

Related Papers Related Patents Related Grants Related Experts
All trials for Neoplasm, Breast All trials for Heart Failure All trials of Echocardiography

-Summary

Rationale: In addition to surgery, effective breast cancer (BC) treatment typically requires chemotherapy, radiotherapy, or both. However, it is still unclear whether patients with BC are at increased risk of long-term cardiac dysfunction due to the adverse effects of these therapies. In a cross-sectional study in primary care, a comparison on cardiac dysfunction between 350 BC survivors and 350 age- and general practitioner (GP)- matched controls without cancer was made. In that study, BC survivors were at increased risk of mild systolic cardiac dysfunction (left ventricle ejection fraction (LVEF)< 54%). By contrast, there was no significant difference in an LVEF < 50% or in diastolic dysfunction. To date it remains uncertain whether the mild or subclinical dysfunction we observed predicts further cardiac deterioration. Consequently, the translation of these results into guidelines for the daily practice of the GP is unclear.

Objective: The aim of the here proposed study is to clarify whether cardiac function in survivors of BC should be monitored by GPs, by assessing whether an unselected population of long-term BC survivors is at increased risk of developing cardiac dysfunction, whether in this group at-risk subgroups exists, and what factors are associated with the highest risk.

Study design: A new assessment of cardiac function among women included in the BLOC-I study. This produces a longitudinal matched cohort design consisting of two cohorts in primary care.

Study population: Survivors of BC, diagnosed ≥11 years ago who received chemotherapy and/or radiotherapy, and a matched reference population with no history of cancer. All participants participated in the Breast cancer Long-term Outcome of Cardiac function (BLOC-I) study.

Main study parameters/endpoints: Left ventricular systolic dysfunction. Systolic cardiac dysfunction is defined as a LVEF <54/50/45%.

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+Arms and interventions

ArmTypeInterventionsDescription
Breast cancer survivorsDiagnostic Test: EchocardiographySurvivors of BC, diagnosed ≥11 years ago, who received chemotherapy and/or radiotherapy
Reference populationDiagnostic Test: EchocardiographyAge and GP matched reference population without a history of cancer
  • Echocardiography (Diagnostic test): During echocardiography, the following parameters will be assessed: * Dimensions * Left ventricle function * Right ventricle function * Valves: Aorta valve and pulmonic valve * Other findings such as: frequency, rhythm, quality

+Outcome measures

Primary outcomes

  • Left ventricular systolic dysfunction [through study completion (from Ocotober 2022 - December 2024)]: Prevalance of systolic cardiac dysfunction defined as a LVEF <54%

Secondary outcomes

  • Clinically used LVEF cut-off points <45% and <50% [through study completion (from Ocotober 2022 - December 2024)]: Prevalance of systolic cardiac dysfunction defined as a LVEF <45% and <50%
  • Course of cardiac function [through study completion (from Ocotober 2022 - December 2024)]: Rate of change of systolic and diastolic cardiac function by change in LVEF
  • Cardiovascular diseases [through study completion (from Ocotober 2022 - December 2024)]: Prevalence of cardiovascular diseases obtained from electronic patient records
  • Symptoms of hearth failure [through study completion (from Ocotober 2022 - December 2024)]: Clinical symptoms of heart failure measured using a self-constructed questionnaire

Other outcomes

  • Patient characteristics [through study completion (from Ocotober 2022 - December 2024)]: age, BMI, menopausal state
  • Physical activity [through study completion (from Ocotober 2022 - December 2024)]: Changes in Physical Acticity measured with Short Questionnaire to Assess Health-enhancing physical activity (SQUASH)
  • Depression [through study completion (from Ocotober 2022 - December 2024)]: Symptoms of depression measured with Hospital Anxiety and Depression Scale - Despression (HADS-D)
  • Anxiety [through study completion (from Ocotober 2022 - December 2024)]: Symptoms of anxiety measured with Hospital Anxiety and Depression Scale - Anxiety (HADS-A)
  • Fatigue [through study completion (from Ocotober 2022 - December 2024)]: Multidimensional assessment of fatigue mesaured with Multidimensional Fatigue Index - 20 (MFI-20).
  • Use of cardiovascular medication [through study completion (from Ocotober 2022 - December 2024)]: Use of cardiovascular medication based on electronic patient records
  • Smoking behavior (self-reported pack years) [through study completion (from Ocotober 2022 - December 2024)]: Smoking behavior

+Eligibility

Sex: Female, accepts healthy volunteers

Inclusion Criteria:

* Patients who previously took part in de BLOC-I study will be included. These criteria were:
* females diagnosed with stage I-III BC at least five years ago or local or locoregional recurrence of BC at least five years ago
* treatment with chemotherapy and/or radiotherapy.

Exclusion Criteria:

* Patients unfit to travel to the hospital due to severe mental or physical illness, based on assessment by their GP.

Exclusion criteria for the BC survivors in the BLOC-I study were:

* metastatic disease at the time of BC diagnosis;
* BC treatment after 80 years of age;
* history of treatment for other types of cancer.

+Locations (1)

FacilityCityCountryStatus
University Medical Center GroningenGroningenNetherlandsRecruiting

+Publications

  • Boerman LM, Maass SWMC, van der Meer P, Gietema JA, Maduro JH, Hummel YM, Berger MY, de Bock GH, Berendsen AJ. Long-term outcome of cardiac function in a population-based cohort of breast cancer survivors: A cross-sectional study. Eur J Cancer. 2017 Aug;81:56-65. doi: 10.1016/j.ejca.2017.05.013. Epub 2017 Jun 8. PMID 28601706