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Brief Title: Preventing Anthracycline Cardiovascular Toxicity With Statins (PREVENT)
Official Title: Preventing Anthracycline Cardiovascular Toxicity With Statins (PREVENT)
Study ID: NCT01988571
Brief Summary: The purpose of this research study is to see if Atorvastatin (Lipitor) 40 mg by mouth daily decreases the chance of developing heart problems in individuals receiving adjuvant anthracycline-based chemotherapy for breast cancer of lymphoma.
Detailed Description: PRIMARY OBJECTIVES: Specific Aim 1: To determine if Atorvastatin(Lipitor) administration preserves left ventricular ejection fraction (LVEF) 24 months after initiation of Anthracycline-based adjuvant therapy for adjuvant treatment of breast cancer or lymphoma. Specific Aim 2: To determine if baseline to 6-month differences in LVEF predict baseline to 24-month differences in LVEF after Anthracycline-based adjuvant therapy and concomitant atorvastatin therapy. To achieve these aims, we will perform a double-blind, placebo-controlled, randomized clinical trial of 0 or 40 mg of atorvastatin/day in 278 individuals scheduled to receive Anthracycline-based chemotherapy for treatment of Stage I-III breast cancer or lymphoma Stage I-IV with a projected \> 2 year life expectancy. We will use innovative noninvasive magnetic resonance imaging (MRI) procedures to accurately measure LVEF. In addition, we will measure left ventricle (LV) volumes, myocardial strain, fibrosis, aortic pulse wave velocity (PWV) and wall thickness, all factors that can influence LVEF by altering LV pre-load, after-load, and contractility.19,20 Advanced serum biomarkers will be measured that assess for the presence of oxidative/nitrosative stress, systemic inflammation and circulating neurohormones that also may influence LVEF. This study will test a new clinical paradigm to manage breast cancer: primary prevention of Anthracycline-based adjuvant therapy-related LV dysfunction using pre-treatment with low-cost statins. In addition, this trial will be the first systematic collection of data regarding the mechanism(s) and time course by which LV dysfunction and subsequent chronic heart failure (CHF) evolve in individuals given Anthracycline-based chemotherapy for breast cancer or lymphoma. These data will be useful to physicians trying to determine the optimal cardiac protection strategies when administering adjuvant chemotherapeutic regimens to their breast cancer or lymphoma patients. The objective of this research is to use inexpensive medications to preserve cardiovascular (CV) health and thereby improve overall survival in the growing number of breast cancer and lymphoma patients. SECONDARY OBJECTIVES Specific Aim 1: To document the effect of Atorvastatin (Lipitor) on cognitive function using a battery of neurocognitive tests (HVLT, Rey-osterrieth Figure, controlled oral word association test (COWA), Trail-making Parts A and B, Digit Span and Grooved Pegboard) in breast cancer and lymphoma patients receiving an anthracycline. Specific Aim 2: To document the effect of Atorvastatin(Lipitor) on self-reported quality of life using validated questionnaires (PROMIS including: General form, Cog Concerns, Cog Abilities, Fatigue, Pain intensity and interference, Sleep Disturbance, Physical Functioning and Social Functioning) in breast cancer and lymphoma patients receiving an anthracycline.
Minimum Age: 21 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, United States
MedStar Georgetown University Hospital, Washington, District of Columbia, United States
MedStar Washington Hospital Center, Washington, District of Columbia, United States
Northwestern University, Chicago, Illinois, United States
University of Chicago Comprehensive Cancer Center, Chicago, Illinois, United States
Cancer Center of Kansas-Wichita Medical Arts Tower, Wichita, Kansas, United States
Cancer Center of Kansas - Wichita, Wichita, Kansas, United States
Ochsner Medical Center Jefferson, New Orleans, Louisiana, United States
Tufts Medical Center, Boston, Massachusetts, United States
Spectrum Health at Butterworth Campus, Grand Rapids, Michigan, United States
William Beaumont Hospital-Royal Oak, Royal Oak, Michigan, United States
William Beaumont Hospital - Troy, Troy, Michigan, United States
Saint John's Hospital - Healtheast, Maplewood, Minnesota, United States
Abbott-Northwestern Hospital, Minneapolis, Minnesota, United States
Mayo Clinic in Rochester, Rochester, Minnesota, United States
Park Nicollet Clinic - Saint Louis Park, Saint Louis Park, Minnesota, United States
Regions Hospital, Saint Paul, Minnesota, United States
United Hospital, Saint Paul, Minnesota, United States
Mission Hospital, Asheville, North Carolina, United States
Hope Women's Cancer Centers-Asheville, Asheville, North Carolina, United States
Cone Health Cancer Center at Alamance Regional, Burlington, North Carolina, United States
Novant Health Presbyterian Medical Center, Charlotte, North Carolina, United States
Oncology Specialists of Charlotte, Charlotte, North Carolina, United States
Cone Health Cancer Center, Greensboro, North Carolina, United States
Novant Health Cancer Institute - Huntersville, Huntersville, North Carolina, United States
Southern Oncology Specialists-Huntersville, Huntersville, North Carolina, United States
Novant Health Cancer Institute - Kernersville, Kernersville, North Carolina, United States
Novant Health Cancer Specialists-Matthews, Matthews, North Carolina, United States
Novant Health Forsyth Medical Center, Winston-Salem, North Carolina, United States
Novant Health Oncology Specialists, Winston-Salem, North Carolina, United States
Wake Forest University Health Sciences, Winston-Salem, North Carolina, United States
Columbus Oncology and Hematology Associates Inc, Columbus, Ohio, United States
Doctors Hospital, Columbus, Ohio, United States
Delaware Health Center-Grady Cancer Center, Delaware, Ohio, United States
Genesis Healthcare System Cancer Care Center, Zanesville, Ohio, United States
Geisinger Medical Center, Danville, Pennsylvania, United States
University of Pennsylvania/Abramson Cancer Center, Philadelphia, Pennsylvania, United States
Medical University of South Carolina, Charleston, South Carolina, United States
Prisma Health Cancer Institute - Easley, Easley, South Carolina, United States
Prisma Health Cancer Institute - Butternut, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Faris, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Eastside, Greenville, South Carolina, United States
Prisma Health Cancer Institute - Seneca, Seneca, South Carolina, United States
Centra Lynchburg Hematology-Oncology Clinic Inc, Lynchburg, Virginia, United States
Virginia Cancer Institute, Richmond, Virginia, United States
Virginia Commonwealth University/Massey Cancer Center, Richmond, Virginia, United States
Shenandoah Oncology PC, Winchester, Virginia, United States
Aurora Cancer Care-Southern Lakes VLCC, Burlington, Wisconsin, United States
Aurora Cancer Care-Grafton, Grafton, Wisconsin, United States
Vince Lombardi Cancer Clinic - Oshkosh, Oshkosh, Wisconsin, United States
Aurora Medical Center in Summit, Summit, Wisconsin, United States
Name: Gregory Hundley, MD
Affiliation: Wake Forest University Health Sciences
Role: PRINCIPAL_INVESTIGATOR