Cardiomyopathy Detection for Cancer Survivors
(CASCADE Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
The trial aims to enhance heart care for adult cancer survivors by developing a nationwide screening program. Participants will undergo tests such as echocardiograms (heart ultrasound) and electrocardiograms (heart’s electrical activity) to monitor heart health, particularly for those treated with anthracycline, a common chemotherapy drug. Two groups are involved: one includes individuals returning for a 1-year follow-up after treatment, and the other includes patients about to start anthracycline treatment. This trial suits adults diagnosed with breast cancer, lymphoma, or sarcoma who have either completed anthracycline therapy or are about to begin it.
As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of people, offering participants a chance to contribute to significant advancements in heart care for cancer survivors.
Do I have to stop taking my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that these methods are safe for cardiovascular monitoring in cancer survivors?
Studies have shown that echocardiograms and electrocardiograms are safe and easy for patients to manage when used to check heart health. Echocardiograms use sound waves to create pictures of the heart and have been successfully used in cancer survivors to detect heart damage, with no major side effects reported. Electrocardiograms, which track the heart's electrical signals, are also commonly used and considered safe.
Research indicates that the NT-pro-BNP blood test, which measures a protein linked to heart stress, is often used to assess heart health in cancer survivors. While higher levels of this protein can indicate risk, the test itself is safe and requires only a simple blood sample. Overall, these tests are non-invasive and generally well-accepted by patients for monitoring heart health.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it aims to improve early detection of cardiomyopathy in cancer survivors using a combination of echocardiograms, electrocardiograms, and NT-pro-BNP tests. Unlike standard tests that may only focus on heart structure, this approach combines structural and biochemical assessments to catch heart issues sooner and more accurately. This comprehensive method has the potential to lead to earlier interventions, possibly preventing severe heart damage in patients who have undergone anthracycline-based chemotherapy.
What evidence suggests that this trial's treatments could be effective for cardiomyopathy detection in cancer survivors?
This trial will assess different methods for detecting cardiomyopathy in cancer survivors. Research has shown that echocardiograms, one of the methods under study, effectively check heart health in cancer patients, especially those who have undergone treatments like chemotherapy. They provide a detailed view of heart function and can identify problems early. Studies indicate that echocardiograms can detect heart issues in about 4.8% of patients with heart-related problems after cancer treatment.
Electrocardiograms (ECGs), another method evaluated in this trial, also help identify heart problems in cancer patients. Research has shown that ECGs can accurately predict heart issues, such as thickening of the heart muscle, with an accuracy rate of 87%.
NT-pro-BNP, the third method under study, is a blood test that can warn of heart problems. High levels of NT-pro-BNP indicate a higher risk of heart failure and other heart issues. Studies have found that high NT-pro-BNP levels are linked to worse outcomes in cancer patients, making it a useful tool for monitoring heart health.678910Who Is on the Research Team?
Joerg Herrmann, MD
Principal Investigator
Mayo Clinic
Are You a Good Fit for This Trial?
Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Pre-Treatment Assessment
Patients are assessed prior to the start of anthracycline-based therapy
Treatment
Participants undergo anthracycline-based chemotherapy
1-Year Follow-up
Participants are monitored for left ventricular dysfunction 1 year after completion of anthracycline-based chemotherapy
What Are the Treatments Tested in This Trial?
Interventions
- Echocardiogram
- Electrocardiogram
- NT-pro-BNP
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
patients presenting before the start of anthracycline-based therapy, then to be followed thereafter for 1 year and thereby contributing to the pool of patients with 1-year post-anthracycline assessment.
patients who were treated in the year before and are now returning for their 1-year follow-up.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Mayo Clinic
Lead Sponsor
Miami Heart Research Institute
Collaborator
Florida Heart Research Institute
Collaborator
Citations
Effectiveness of surveillance by echocardiography for ...
The main findings of this study were 1) the composite outcome of CTRCD and acute heart failure was present in 4.8 % of the patients with breast cancer ...
Progress in the Use of Echocardiography in Patients with ...
Echocardiography allows for a comprehensive non-invasive assessment at all cancer stages, it is well suited to monitor cardiovascular disease secondary to ...
3.
ccss.stjude.org
ccss.stjude.org/content/dam/en_US/shared/ccss/documents/concept-prop/concept-proposal%2023-05_2023-02-24T14_56_12.pdfEvaluation of cardiovascular health outcomes among ...
Adult survivors of childhood cancer are at risk for late-onset cardiomyopathy due to prior anthracycline and cardiac radiation exposure, yet ...
Echocardiographic monitoring in cancer therapy: clinical ...
This review provides a practical and comprehensive framework for the echocardiographic assessment of oncology patients, focusing on both ...
Cancer and Cardiovascular Disease: The Use of Novel ...
Strain echocardiography has been used to predict outcomes after acute MI [52-54], infiltrative cardiomyopathy, and clinical outcomes in systolic heart failure ...
Screening Adult Survivors of Childhood Cancer for ...
Detection of cardiomyopathy was improved (sensitivity, 75%) by using a higher 2D echocardiography cutoff (EF < 60%) to detect an EF less than 50% by the ...
Cardiovascular Imaging in Contemporary Cardio-Oncology
Advances in cancer therapeutics have led to dramatic improvements in survival, now inclusive of nearly 20 million patients and rising.
JACC Journals Publish Latest Science From AHA 2025
At a median 2.8-year follow-up, results showed the ECV had a strong prognostic ability with <30% excluded and ≥40% confirmed cardiac involvement ...
Cardiac Safety of Reduced Cardiotoxicity Surveillance ...
This study evaluated the cardiac safety of reduced CTRCD surveillance performed every 6 months during non-anthracycline HER2-targeted treatment.
Cardiovascular Considerations After Cancer Therapy
Cancer survivors incur a 2- to 5-fold higher risk of mortality from cardiovascular disease compared with the general population.1, 2, 3 The cardiovascular risk ...
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