Effects of Dexrazoxane Hydrochloride on Biomarkers Associated With Cardiomyopathy and Heart Failure After Cancer Treatment (HEART)

Study Description

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Brief Summary:

This clinical trial studies the effects of dexrazoxane hydrochloride on biomarkers associated with cardiomyopathy and heart failure after cancer treatment. Studying samples of blood in the laboratory from patients receiving dexrazoxane hydrochloride may help doctors learn more about the effects of dexrazoxane hydrochloride on cells. It may also help doctors understand how well patients respond to treatment.

Condition or disease

Intervention/treatment

Recurrent Adult Hodgkin Lymphoma; Recurrent Adult T-Cell Leukemia/Lymphoma; Refractory Childhood Hodgkin Lymphoma; Stage I Adult Hodgkin Lymphoma; Stage I Adult T-Cell Leukemia/Lymphoma; Stage I Childhood Hodgkin Lymphoma; Stage II Adult Hodgkin Lymphoma; Stage II Adult T-Cell Leukemia/Lymphoma; Stage II Childhood Hodgkin Lymphoma; Stage III Adult Hodgkin Lymphoma; Stage III Adult T-Cell Leukemia/Lymphoma; Stage III Childhood Hodgkin Lymphoma; Stage IV Adult Hodgkin Lymphoma; Stage IV Adult T-Cell Leukemia/Lymphoma; Stage IV Childhood Hodgkin Lymphoma

Other: Assessment of Therapy Complications; Other: Laboratory Biomarker Analysis; Other: Quality-of-Life Assessment; Other: Questionnaire Administration

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine whether patients randomized to the experimental dexrazoxane hydrochloride (DRZ) arms have decreased markers of cardiomyopathy/heart failure (CHF) compared with patients on the standard arm.

II. To evaluate whether the cardioprotective effect of DRZ is modified by anthracycline (anthracycline analogue GPX-150) dose, chest radiation, and demographic factors (age at cancer diagnosis, current age, sex).

SECONDARY OBJECTIVES:

I. To determine whether patients on the DRZ arms experienced differential rates of overall-survival and event-free survival compared with the standard therapy arms.

II. To determine whether projected quality-adjusted life years (QALY) differed by randomization status, accounting for premature cardiac disease, primary disease relapse, and second cancers.

OUTLINE:

Patients complete a diagnostic symptom checklist, undergo a physical exam, echocardiogram, collection of serum for biomarker testing, and a 6 minute walk test, and complete quality of life, family history, physical activity, and smoking questionnaires.

Study Design

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Study Type :	Observational
Estimated Enrollment :	420 participants
Observational Model:	Case-Only
Time Perspective:	Prospective
Official Title:	Health Effects After Anthracycline and Radiation Therapy (HEART): Dexrazoxane and Prevention of Anthracycline-Related Cardiomyopathy
Study Start Date :	August 2013
Estimated Primary Completion Date :	January 2019

Groups and Cohorts

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Group/Cohort	Intervention/treatment
Ancillary-Correlative (laboratory biomarker analysis); Patients complete a diagnostic symptom checklist, undergo a physical exam, echocardiogram, collection of serum for biomarker testing, and a 6 minute walk test, and complete quality of life, family history, physical activity, and smoking questionnaires.	Other: Assessment of Therapy Complications; Ancillary studies Other: Laboratory Biomarker Analysis; Correlative studies Other: Quality-of-Life Assessment; Ancillary studies; Other Name: Quality of Life Assessment Other: Questionnaire Administration; Ancillary studies

Outcome Measures

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Primary Outcome Measures :

1. Left ventricular thickness-to-dimension ratio assessed using standard 2-dimensional. [ Time Frame: Baseline ]
   Univariate tests will be used as well as examination of the entire cohort via multivariable regression adjusting for all a priori covariates of interest.
2. Left ventricular thickness-to-dimension ratio assessed using M-mode. [ Time Frame: Baseline ]
   Univariate tests will be used as well as examination of the entire cohort via multivariable regression adjusting for all a priori covariates of interest.
3. Left ventricular thickness-to-dimension ratio assessed using Doppler echocardiogram. [ Time Frame: Baseline ]
   Univariate tests will be used as well as examination of the entire cohort via multivariable regression adjusting for all a priori covariates of interest.

Secondary Outcome Measures :

1. Differences in serum biomarkers (particularly cardiac troponins and natriuretic peptides) [ Time Frame: Baseline ]
2. Primary disease relapse [ Time Frame: Baseline ]
   An analytic Markov model will be created and used.
3. Quality of life based on self-report instruments [ Time Frame: Baseline ]
   An analytic Markov model will be created and used. Estimates and their 95% confidence will be included to explore the sensitivity of any QALY estimates.
4. Second cancer rates [ Time Frame: Baseline ]
   An analytic Markov model will be created and used.

Eligibility Criteria

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Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No
Sampling Method:	Probability Sample

Study Population

Patients with T-cell leukemia/lymphoma or Hodgkin lymphoma enrolled on Pediatric Oncology Group (POG) 9404, 9425, 9426.

Criteria

Inclusion Criteria:

• Previously enrolled and randomized on POG 9404, 9425, or 9426
• STRATUM I: Alive and in continuous first complete remission from their original cancer (T-cell leukemia/lymphoma [POG 9404] or Hodgkin lymphoma [POG 9425/9426])
• STRATUM I: Not have been diagnosed with any subsequent malignancy, with the exception of non-melanomatous skin cancer(s); patients with history of only subsequent non-melanomatous skin cancers remain eligible
• STRATUM I: All patients and/or their parents or legal guardians must sign a written informed consent
• Among patients who have relapsed or have experienced a subsequent malignancy other than non-melanomatous skin cancer since their original diagnosis, the study committee will review the available data (both from Children's Oncology Group's [COG's] Statistics and Data Center [SDC] and the participating institution) to determine if individual patients are to be selected for Stratum 2; in recognition that local institutions sometimes have more updated relapse/subsequent cancer data than SDC, in cases where local data is more updated, local data will be used preferentially; the study will petition the Institutional Review Board (IRB) specifically for a waiver of consent to include any relapse and subsequent cancer data obtained from existing records for analysis of the secondary aims; patients selected for Stratum 2 will be those for whom late relapse or subsequent cancer is reported but who lack clear confirmation in existing records (either at SDC or at the local institution)
• STRATUM II: Alive, but have experienced relapse of their original cancer and/or have developed a subsequent cancer (other than non-melanomatous skin cancer) since their original diagnosis
• STRATUM II: All patients and/or their parents or legal guardians must sign a written informed consent
• For all participants, all institutional, Food and Drug Administration (FDA), and National Cancer Institute (NCI) requirements for human studies must be met; finally, the coordinating center will create a master list using SDC records and those of local institutions of patients to be approached; patients who otherwise appear to be eligible for Stratum 1 or 2 not identified on this list cannot be enrolled without prior approval from the study chair

Contacts and Locations

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  Show 55 Study Locations

Sponsors and Collaborators

Children's Oncology Group

National Cancer Institute (NCI)

Investigators

Principal Investigator:	Eric Chow	Children's Oncology Group

More Information

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Study Description Study Design Groups and Cohorts Outcome Measures Eligibility Criteria Contacts and Locations More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Chow EJ, Asselin BL, Schwartz CL, Doody DR, Leisenring WM, Aggarwal S, Baker KS, Bhatia S, Constine LS, Freyer DR, Lipshultz SE, Armenian SH. Late Mortality After Dexrazoxane Treatment: A Report From the Children's Oncology Group. J Clin Oncol. 2015 Aug 20;33(24):2639-45. doi: 10.1200/JCO.2014.59.4473. Epub 2015 May 26.

Responsible Party:	Children's Oncology Group
ClinicalTrials.gov Identifier:	NCT01790152 History of Changes
Other Study ID Numbers:	ALTE11C2; NCI-2012-03196 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ); S0004187; ALTE11C2 ( Other Identifier: Childrens Oncology Group ); ALTE11C2 ( Other Identifier: DCP ); ALTE11C2 ( Other Identifier: CTEP ); U10CA095861 ( U.S. NIH Grant/Contract ); UG1CA189955 ( U.S. NIH Grant/Contract )
First Posted:	February 13, 2013
Last Update Posted:	October 31, 2017
Last Verified:	October 2017

Additional relevant MeSH terms:

Lymphoma; Leukemia; Hodgkin Disease; Cardiomyopathies; Leukemia, T-Cell; Leukemia-Lymphoma, Adult T-Cell; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Immune System Diseases; Heart Diseases; Cardiovascular Diseases	Leukemia, Lymphoid; Dexrazoxane; Razoxane; Antineoplastic Agents; Cardiotonic Agents; Topoisomerase II Inhibitors; Topoisomerase Inhibitors; Enzyme Inhibitors; Molecular Mechanisms of Pharmacological Action; Protective Agents; Physiological Effects of Drugs; Antimitotic Agents; Mitosis Modulators