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Doctors at American City of Hope Hospital, in collaboration with the Children’s Oncology Group (COG), have conducted the largest clinical trial to date aimed at reducing the risk of childhood cancer survivors developing heart failure.
The results of the study, published in The Lancet Oncology, show that carvedilol, a drug used to relax blood vessels, is safe for childhood cancer survivors and may improve key markers of heart damage caused by chemotherapy are.
A devastating long-term side effect of a chemotherapy treatment called anthracycline is the increased risk of heart failure, in which the heart cannot pump enough blood to meet the body’s needs.
This is a delayed process in which the heart undergoes gradual changes over time, characterized by thinning of the heart muscle and enlargement of its chambers.
Unfortunately, the cascade of clinical events following the onset of deterioration in cardiac function is irreversible, highlighting the urgent need for early prevention strategies.
“The growing number of childhood cancer survivors makes the development of early interventions essential. Simply helping children survive cancer is not enough. “We also need to optimize patients’ health so they don’t have to deal with life-threatening side effects decades after escaping cancer,” said Dr. Saro H. Armenian of the City of Hope Childhood Cancer Center corresponds to the author of the study in The Lancet Oncology.
City of Hope physicians led the Phase IIb, randomized, double-blind clinical trial at 30 hospitals in the United States and Canada (COG Trial ID: ALTE1621).
About 182 enrolled participants took relatively low doses of carvedilol or an equivalent placebo for two years.
There were no significant differences in side effects between the two study arms and carvedilol appeared to be well tolerated.
Although the clinical trial did not achieve its goal of reducing heart muscle thinning and ventricle enlargement, there were significant improvements in left ventricular postsystolic wall stress (ESWS), a biomarker of worsening heart failure. Heart health.
The greatest benefit was seen in participants who survived for very long periods of time and in those who were highly adherent to study medication.
In addition, of the eight patients who experienced clinically significant deterioration in cardiac function during the study, six were randomized to placebo and two to carvedilol.
The research paves the way for a Phase III clinical trial that could demonstrate significant benefit for certain patients who are at particularly high risk of irreversible deterioration in heart function after completing cancer treatment.
“Future studies need to focus on the optimal timing, duration and population for carvedilol intervention,” adds Dr. Douglas S. Hawkins, president of the COG Group and professor of hematology-oncology at Seattle Children’s Hospital.
The research is an important first step in the development of future studies aimed at optimizing the long-term health of survivors who are expected to live for decades after their initial cancer diagnosis.
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