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Lay Description

This phase IIb trial studies how well low-dose carvedilol works in preventing heart failure in cancer survivors exposed to high dose anthracyclines for management of childhood cancer. Patients who received high-dose anthracycline chemotherapy are at a much greater risk for developing heart failure compared to survivors who didn't get any anthracycline chemotherapy. Heart failure happens when the heart muscle has been weakened and can't pump blood as well as it should. Carvedilol may help lower the risk of cardiovascular complications.

Category

  • Cancers and Other Neoplasms
  • Child Health
  • Heart, Vascular and Blood
  • Multiple Sites
IRB Number
20160394HU
NCT Number
NCT02717507
Open to Enrollment
Yes

Eligibility

Eligible Ages
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Males and females must weigh >= 40 Kg
  • Patient must have had a cancer diagnosis < 22 years of age, irrespective of current age
  • Patient must have a lifetime cumulative anthracycline dose of >= 250 mg/m^2 DOXOrubicin equivalent without the protection of dexrazoxane (Zinecard) therapy; the anthracycline dose threshold must be met as part of the treatment of a cancer that was diagnosed at < 22 years of age

    • Note: Institutional records (e.g., clinic note, treatment summary, chemotherapy roadmap) can be used to document lifetime receipt of anthracycline dose
  • Patient must have completed cancer treatment >= 2 years prior to study enrollment

Exclusion Criteria

  • Receiving treatment for cardiomyopathy or heart failure
  • Ejection fraction of < 50% (by radionuclide angiogram or echocardiogram) or shortening fraction of < 25% (by echocardiogram)

    • Note: for instances where both are reported, and one is below the threshold, the site will have the option to re-measure it centrally at the core lab
  • Uncorrected primary obstructive or severe regurgitative valvular disease:

    • Nondilated (restrictive); or
    • Hypertrophic cardiomyopathy; or
    • Significant systemic ventricular outflow obstruction
  • Sustained or symptomatic ventricular dysrhythmias uncontrolled with drug therapy or implantable device
  • Significant conduction defects (i.e. second or third degree atrio-ventricular block or sick sinus syndrome)
  • Bradycardia: heart rate < 50 beats per minute (BPM)
  • Use of an investigational drug or beta adrenergic blockers, including metoprolol, sotalol, within 30 days of enrollment
  • History of drug sensitivity or allergic reaction to alpha or beta-blockers
  • Low resting systolic blood pressure: < 90 mmHg
  • Use of any other blood pressure lowering medication for treatment of hypertension within 30 days of enrollment except calcium channel blockers and diuretics
  • History or current clinical evidence of moderate-to-severe obstructive pulmonary disease or reactive airway diseases (i.e. asthma) requiring therapy
  • Serum aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) > 3 times upper limit of institutional normal
  • Gastrointestinal, or biliary disorders that could impair absorption, metabolism, or excretion of orally administered medications
  • Endocrine disorders (such as primary aldosteronism, pheochromocytoma, hyper- or hypothyroidism) not controlled with medication
  • Uncontrolled diabetes (controlled diabetes per the American Diabetes Association and International Diabetes Center's Glycemic Target Goals is hemoglobin A1C < 7%)
  • Anemia (hematocrit < 28%)
  • Currently using select CYP2D6 inhibitor or inducer medications
  • Inability to swallow pills
  • Female patients who are pregnant are not eligible; women of childbearing potential require a negative pregnancy test prior to starting study drug
  • Lactating females are not eligible unless they have agreed to not breastfeed their infants
  • Sexually active female patients of reproductive potential are not eligible unless they agree to use an effective contraceptive method during study and for 2 months after stopping the study drug; abstinence is an acceptable method of birth control
  • All patients and/or their parents or legal guardians must sign a written informed consent
  • All institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met

Study Design

Arm Groups

Study Contact


Principal Investigator
Anne-Marie Langevin