Neoplasms

Digestive System Diseases

All Conditions

Gland and Hormone Related Diseases

Heart and Blood Diseases

Symptoms and General Pathology

Substance Related Disorders

Wounds and Injuries

Rare Diseases

Stomach Neoplasms

Pancreatic Neoplasms

Cardiotoxicity

Esophageal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Heart Diseases

Drug-Related Side Effects and Adverse Reactions

Chemically-Induced Disorders

Radiation Injuries

Head and Neck Neoplasms

Esophageal Diseases

Stomach Cancer

Esophageal Cancer

Pancreatic Cancer

Stable patients with gastrointestinal malignancies will be recruited to this 3 timepoint study prior to initiation of fluoropyrimidine chemotherapy. All investigations will be performed at baseline, at the end of cycle 1 and 4-6 weeks post completion of treatment.

Patients with gastrointestinal malignancies presenting to hospital with acute symptoms of fluoropyrimidine cardiotoxicity. All investigations will be performed during the acute presentation and the second visit will be performed 4-6 weeks post completion of treatment.

Cardiac MRI scan to assess changes in left ventricular function, parametric mapping, strain and myocardial blood flow. In cohort 1 this will be performed pre, during and on completion of treatment. In cohort 2 this will be performed during the acute presentation and on completion of treatment.

Cardiovascular magnetic resonance with stress perfusion

CT coronary angiogram at baseline only in both cohorts to assess for coronary artery disease

CT coronary angiography

Retinal OCTa to assess changes in retinal vasculature. In cohort 1 this will be performed pre, during and on completion of treatment. In cohort 2 this will be performed during the acute presentation and on completion of treatment.

Retinal OCT angiography

To determine changes in sublingual microvascular health. In cohort 1 this will be performed pre, during and on completion of treatment. In cohort 2 this will be performed during the acute presentation and on completion of treatment.

Sublingual microscopy (GlycoCheck)

Performed to assess for myocardial injury. In cohort 1 this will be performed pre, during and on completion of treatment. In cohort 2 this will be performed during the acute presentation and on completion of treatment.

Serum cardiac biomarkers (High sensitivity troponin, NT pro BNP)

Aderonke Abiodun, MBChB

Charlotte Manisty, PhD

Malcolm Walker, MD

Observational prospective cohort study designed to assess the mechanisms of fluoropyrimidine induced cardiovascular toxicity.

Fluoropyrimidine (5-FU and Capecitabine) based chemotherapy regimens form the cornerstone of treatments for gastrointestinal (GI) cancers. Fluoropyrimidines however, are associated with the development of cardiovascular toxicity which can take on different forms including chest pain, myocardial infarction, arrhythmias, heart failure and sudden death. The underlying mechanisms of cardiovascular toxicity are not fully understood.

The investigators will use quantitative cardiovascular magnetic resonance perfusion imaging, CT coronary angiography, extra-cardiac vascular assessments and serum cardiac biomarkers to improve insights into the pathophysiology of fluoropyrimidine cardiotoxicity. All enrolled participants in this two centre study will have GI cancers requiring treatment with fluoropyrimidine chemotherapy.

Cancer Treatment Related Cardiovascular Toxicity: Comprehensive Myocardial and Vascular Phenotyping

Assessed at baseline, following cycle 1 and 4-6 weeks post completion of treatment

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Cancer Treatment Related Cardiovascular Toxicity: Comprehensive Myocardial and Vascular Phenotyping	NCT06048458	Cardiovascular ... Cardiotoxicity Fluorouracil Ad... Malignancy Colorectal Canc... Oesophagus Canc... Gastric Cancer Pancreatic Canc...	Cardiovascular ... CT coronary ang... Retinal OCT ang... Sublingual micr... Serum cardiac b...	18 Years -	University College, London
Cancer Treatment Related Cardiovascular Toxicity: Comprehensive Myocardial and Vascular Phenotyping	NCT06048458	Cardiovascular ... Cardiotoxicity Fluorouracil Ad... Malignancy Colorectal Canc... Oesophagus Canc... Gastric Cancer Pancreatic Canc...	Cardiovascular ... CT coronary ang... Retinal OCT ang... Sublingual micr... Serum cardiac b...	18 Years -	University College, London

Spots Global Cancer Trial Database for fluorouracil adverse reaction