ClinicalTrials.gg
CompletedNCT03266809CARE-BUpdated Dec 1, 2022

CARdiac Function Evaluation in Breast Cancer Patients

An observational study in Breast Cancer Female, sponsored by Swansea University. Completed at 1 site in United Kingdom. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2022-12-01.

Sponsored by Swansea University · Observational

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Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
17
Ages
18 Years and older
Sex
Female
01

Where this study stands

Counted across the records on this site · 2026-11-14

Among 757 studies in Breast Neoplasms with a site in United Kingdom — 98 open to participants now, 196 under way, 67 of them phase 3. Breast Neoplasms · United Kingdom.

Enrollment
115th of 122
17 · median 221
Started
2017
with 36 others
Observational
123 of 757
30 open now
Registered
458th of 757
by date

Among the 757 studies in Breast Neoplasms with a site in United Kingdom, this one is the 115th largest by enrollment of the 122 observational ones that give a count, is one of 37 that started in 2017, is one of 123 observational ones, and was the 458th registered.

Breast Neoplasms

14,832 studies on the registry are indexed under Breast Neoplasms; 3,320 are open to participants now.

Browse Breast Neoplasms studies →

Open to participants now

98 of the 757 studies in Breast Neoplasms with a site in United Kingdom are open now. Recruiting first, the newest first:

93 more — sign in →

All 98 open studies →

A study can be open while its sites in United Kingdom have not opened yet or have stopped. Only those recruiting at a site in United Kingdom →

Who these studies take

Of the 2,399 Breast Neoplasms studies recruiting now, 1,570 (65%) set no upper age limit and 592 (25%) stop at 75 or younger; 103 take children under 18; 215 take healthy volunteers.

This study: 18 Years and older · female · no healthy volunteers.

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02

Study summary

This study will investigate the influence of systemic adjuvant/neoadjuvant therapy (SAT: chemotherapy +/- anti-HER2 antibodies (trastuzumab +/- pertuzumab) on heart function/rhythm and cardio-respiratory fitness in recently diagnosed breast cancer patients. In some patients, SAT damages the heart (so-called 'cardiotoxicity') and this can have a serious impact on the patient's quality of life and overall survival. It has also been suggested that anticancer therapies may lead to repolarization abnormalities, QT prolongation and autonomic dysfunction, clinically reflected by an increase in HR and a reduction in heart rate variability (HRV). There is a lack of information in the literature regarding the extent and time-course of changes in cardiac function, cardiac rhythm and cardio-respiratory performance ('fitness') in these patients. Moreover, the differential influences of specific treatment regimes (e.g. SAT or SAT plus radiotherapy) and different chemotherapy drugs on cardio-respiratory performance remain unclear. A better understanding of these issues is the primary aim of this study.

Read the detailed description

This study will focus on the following:

  1. Cardiac function assessment: The conventional method for assessing heart function (in terms of 'ejection fraction') in patients being treated for cancer uses nuclear medicine (MUGA scan). MRI can also provide this information but it is not typically used for cardiac function assessment in these patients. MUGA scans are typically performed before chemotherapy in selected patients at higher risk of cardiotoxicity and in all cases before starting anti-HER2 antibody treatment (trastuzumab, pertuzumab). Patients receiving anti-HER2 antibody treatment receive repeat cardiac assessments at 3-4 month intervals until the completion of treatment - it is not practical or cost-effective to scan more frequently. This study will determine whether an alternative and inexpensive method for monitoring heart function (Impedance Cardiography, ICG) can adequately quantify changes in ejection fraction during treatment. If it can, then this technique could be used more frequently during and following treatment, with the aim of determining the treatment stages during which the heart is most at risk of damage. The ability of ICG to dynamically characterise a relatively rapid decline in cardiac function in breast cancer patients has not been established. Neither has its performance been compared with MRI or MUGA in this population. This study will investigate whether ICG is a sufficiently accurate and reliable alternative to MRI/MUGA for determining cardiac dysfunction during and following cancer treatment.
  2. Cardiac rhythm and autonomic function assessment: Heart rate variability (HRV) reflects the modulation of the heart by the autonomic nervous system, and it can be quantified using several different methods based on analysis of the temporal changes between successive heartbeats. The development of autonomic dysfunction in breast cancer patients has been shown in a few small clinical studies, but the majority of these studies have considered HR rather than HRV, which is a much less robust measure of autonomic function. The few studies that have used HRV analysis have demonstrated significant reductions in HRV following the completion of anthracycline-based therapy. Previous research on other ECG markers (e.g. QT and QRS duration) in breast cancer patients has mainly focused on anthracycline-based regimes; the influence of trastuzumab treatment on ECG makers has been evaluated in only two studies to date. It is still not clear whether these changes can predict subsequent LV dysfunction although QT variability is a possible marker of myocardial contractility and has been shown to increase as a result of anthracycline therapy in breast cancer patients. This study aims to characterise the impact of different treatment regimes on the temporal properties of the ECG and will compare beat-to-beat QT variability and beat-to-beat T wave variability in breast cancer patients receiving a range of treatment regimes.
  3. Body composition and cardiorespiratory fitness assessment: This study also aims to characterise the patterns of change in body composition, physical activity and cardiorespiratory fitness in breast cancer patients. The study will examine whether these modifiable factors might influence a patient's susceptibility to cardiac changes during treatment and, in turn, how these factors are affected by treatment. Of particular interest, it has been suggested that cardiorespiratory fitness (measured by the rate of oxygen uptake) is impaired in breast cancer patients compared to healthy controls, even seven years following the completion of treatment. Oxygen-uptake analysis will be performed in this study to explore possible compensatory mechanisms for abnormal pathology- or treatment-induced cardiac function in breast cancer patients. Fitness, physical activity and body composition will be assessed quantitatively using a range of objective techniques, including cardiopulmonary exercise testing on a cycle ergometer (fitness) with breath-by-breath gas analysis (cardiorespiratory function), accelerometery (activity levels) and DEXA radiography scans (body composition).

The main research questions in this study are:

  1. Is the CARE-B protocol practically feasible and tolerable to early-stage breast cancer patients?
  2. What is the level of agreement between cardiac (ventricular) function determined using cardiac MRI, MUGA and Impedance Cardiography in breast cancer patients receiving SAT?
  3. Is cardiac rhythm (heart rate and QT variability) altered in breast cancer patients receiving SAT?
  4. Is oxygen transport and oxygen uptake into tissue altered in breast cancer patients receiving SAT?
  5. Does a patient's baseline physical activity, fitness and body composition affect their susceptibilities to treatment-induced cardio-respiratory problems?
  6. Does a patient's physical activity, physical fitness and body composition change appreciably during SAT in these patients?
03

Conditions studied

  • Breast Cancer Female

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Keywords

  • Cardiac function
  • Cardio-toxicity
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Women aged 18 years or older who have early invasive breast cancer and who are due to begin adjuvant or neoadjuvant therapy for this condition, but who are otherwise free of major cardiovascular or chronic respiratory disease and who are capable of undertaking physical exercise.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

Eligible participants will be women aged 18 years or over with the following characteristics:

  • Early invasive breast cancer (stage I-III)
  • Due to start or neoadjuvant therapy including either anthracycline-based chemotherapy, or chemotherapy + trastuzumab +/- pertuzumab
  • \<=2
  • Absence of major cardiovascular or chronic respiratory problems, or other conditions that in the opinion of the clinician would contraindicate the use of physical exercise assessments
  • Absence of for MRI scans, as listed in Paragraph 3.3. Patients unsuitable or unwilling to undergo MRI scans will be eligible for the study only if they are planned to receive trastuzumab, since this will include monitoring with MUGA scans or echocardiograms as part of routine care
  • Provision of signed .

Exclusion criteria

Exclusion Criteria:

  • Presence of major cardiovascular or chronic respiratory problems, or other conditions that in the opinion of the clinician would contraindicate the use of treadmill exercise assessments
  • Presence of for MRI scans:

    • Internal electronic devices such as neurostimulators or defibrillators
    • Replacement heart valve
    • Cardiac pacemaker
    • Intracranial vessel clips
    • Internal ear implant
    • Claustrophobia
    • Pregnancy.

MRI scans will be requested by a clinician after the exclusion of the above contraindications. Patients unsuitable or unwilling to undergo MRI scans will be eligible for the study only if they are planned to receive trastuzumab, since this includes monitoring with MUGA scans or echocardiograms as part of routine care.

Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Adjuvant and neoadjuvant

Neoadjuvant treatment is given before the main treatment (usually surgery), often to shrink a tumour. Adjuvant treatment is given after it, to lower the chance of the cancer coming back.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
17 participants (actual)
Patient registry
No

Groups and cohorts

  • Breast Cancer Patients

    Eligible participants will be women aged 18 years or over who have the following main characteristics: * Early invasive breast cancer (stage I-III) * Due to start SAT (adjuvant or neoadjuvant chemotherapy +/- trastuzumab +/- pertuzumab) * WHO performance status 0-2.

This study also gives Trastuzumab, Pertuzumab. No intervention listed here names it: that was found by reading the record.

06

What researchers measure

Primary outcomes

  1. Cardiac Function (stroke volume or ejection fraction)

    Cardiac function during/following treatment in breast cancer patients.

    Time frame: At completion of treatment, an average of 13 months

  2. Cardiac Rhythm (heart rate variability)

    Cardiac rhythm during/following treatment in breast cancer patients.

    Time frame: At completion of treatment, an average of 13 months

Secondary outcomes

  1. Physical activity level (accelerometer-based activity level 'counts')

    Physical activity level during/following treatment in breast cancer patients.

    Time frame: At completion of treatment, an average of 13 months

  2. Cardiorespiratory function (rate of respiratory oxygen uptake)

    Cardiorespiratory function during/following treatment in breast cancer patients.

    Time frame: At completion of treatment, an average of 13 months

  3. Body mass composition (from DEXA scan)

    Body fat mass and fat-free mass, and bone mineral density

    Time frame: At completion of treatment, an average of 13 months

07

Study locations

1 site
  • Singleton Hospital
    Swansea, Wales SA2 8PP, United Kingdom
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Aug 2017 to primary completion in Sep 2019, 25 months.

Of 1,192 non-industry observational studies under Breast Neoplasms, half reached primary completion within 58 months of starting (the median), counting those still running; a quarter within 25 and three quarters within 138. This study's 25 months is below that.

Counting every sponsor, half of 1,381 studies reached it within 55 months; a quarter within 25 and three quarters within 125.

How these figures are worked out, and which studies are left out of them.

Registered
Aug 25, 2017
First posted
Aug 30, 2017
StartActual
Aug 1, 2017
Primary completionActual
Sep 28, 2019
CompletionActual
Apr 1, 2020
Last update
Dec 1, 2022
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Dec 1, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03266809
Lead sponsor
Swansea University
Collaborators
Abertawe Bro Morgannwg University Health Board
Responsible party
Prof Michael Lewis (Professor, Swansea University) — Principal investigator
First posted
Aug 30, 2017
Start date
Aug 1, 2017
Primary completion
Sep 28, 2019
Completion
Apr 1, 2020
Last update
Dec 1, 2022

Study contacts

Professor Lewis
study director · Swansea University

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Nov 2022. You cannot join it, but the record below documents what was studied.

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