JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

A strain-guided trial of cardioprotection in early-stage breast cancer patients on anti-HER2 therapy (PROTECT HER2)

  • 0Division of Cardiovascular Medicine, Department of Medicine, Feinberg School of Medicine, Northwestern University, 676 N. St. Clair, Suite 600, Chicago, IL, 60611, USA.
Cardio-Oncology (london, England) +

|

November 28, 2024

|

November 28, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Prophylactic carvedilol did not significantly improve cardiac function in HER2+ breast cancer patients. Strain-guided therapy showed no benefit in preventing cancer-therapy related cardiac dysfunction (CTRCD).

Area Of Science

  • Cardiology
  • Oncology
  • Pharmacology

Background

  • Global longitudinal strain (GLS) is used to detect patients at risk for cancer-therapy related cardiac dysfunction (CTRCD).
  • Limited data exists on strain-guided cardioprotective therapy for early-stage HER2+ breast cancer patients on non-anthracycline regimens.
  • This study evaluated carvedilol's effectiveness in preventing CTRCD using a GLS-guided strategy.

Purpose Of The Study

  • To assess if a strain-guided strategy with carvedilol prevents CTRCD in HER2+ breast cancer patients.
  • To evaluate GLS stability as the primary endpoint.
  • To determine secondary endpoints including CTRCD development and anti-HER2 treatment interruption rates.

Main Methods

  • Prospective randomized clinical trial with four arms.
  • Patients with normal LVEF and GLS were in Arm A.
  • Patients with GLS decrease (>15% or < -15%) were randomized to carvedilol (Arm B) or no therapy (Arm C); those developing CTRCD were in Arm D.

Main Results

  • 110 patients completed follow-up; 84 in Arm A, 10 each in Arms B and C, 6 in Arm D.
  • No significant differences in GLS stability, CTRCD development, or completed cancer therapy cycles were observed between groups.
  • Carvedilol initiation based on GLS changes did not show a significant benefit.

Conclusions

  • Prophylactic carvedilol guided by GLS did not significantly improve GLS stability or prevent CTRCD in this patient group.
  • No significant difference in trastuzumab cycles held between groups.
  • Findings suggest a low-risk group may benefit from less intensive cardiac surveillance.

Keywords: