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The anthracycline doxorubicin, first introduced in the 1960's, continues to be an effectively utilized antineoplastic drug. Even at relatively low cumulative doses there is risk of cardiotoxicity. However, the incidence of subclinical cardiotoxicity is not known, carrying a potential risk for late effects in cancer survivors. Doxorubicin has systemic toxicity that may contribute to cardiac metabolic stress, but the main cardiotoxic mechanism involves cardiac mitochondria. The goal of this study is to detect early changes in the mitochondrial metabolism in situ as a marker for subclinical doxorubicin induced cardiotoxicity.
This is a prospective, single-center study in women and men with breast cancer requiring doxorubicin treatment. The study will be conducted in parallel to the standard clinical care, at dedicated visits.
In this study patients will undergo a cardiac magnetic resonance (MR) signal detection after injection of hyperpolarized carbon-13 pyruvate. The study will be performed before the course of doxorubicin, and after completing doxorubicin treatment.
Patients will be screened prior to enrollment based on study specific inclusion and exclusion criteria and MRI safety criteria.
On the day of the metabolic cardiac MR scan an IV line will be inserted and the participant will receive a bolus of oral glucose. The ingestion of glucose will be required to prepare the state of the heart for metabolic imaging. Following this preparation the participant will undergo a cardiac MR study of about 45 minutes, including carbon-13 dedicated sequences.
A separate dedicated cardiac MRI session may be completed in certain participants.
In part I 10 patients will be studied after completion of doxorubicin therapy for correlation with cardiac mechanical function.
In part II up to 100 patients will be studied before and after completion of doxorubicin therapy for identification of subclinical cardiac metabolic changes.
Formal study using hyperpolarized 13C-pyruvate injection, Feasible study using hyperpolarized 13C-pyruvate injection
UT Southwestern - Advanced Imaging Research Center
Enrolling by invitation
University of Texas Southwestern Medical Center
Published on BioPortfolio: 2018-10-02T08:45:18-0400
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