Breast CancerPhase 2NCT01009918
Lisinopril or Coreg CR® in Reducing Side Effects in Women With Breast Cancer Receiving Trastuzumab
A Phase 2 study testing Coreg CR® and lisinopril in people with Breast Cancer and Cardiac Toxicity, run by University of South Florida at 174 sites in United States.
Trial summary
RATIONALE: Lisinopril or Coreg CR®, may help reduce side effects caused by trastuzumab. It is not yet known whether lisinopril or Coreg CR® are more effective than a placebo in reducing side effects caused by trastuzumab. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Breast Cancer, Cardiac Toxicity
- What is being tested?
- Coreg CR® and lisinopril
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 468 participants
- Where
- 174 sitesUnited States
- Study dates
- Mar 2010to Nov 2018
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Males and Females ≥ 18 years old diagnosed with HER2 positive breast cancer
- Scheduled to receive neoadjuvant or adjuvant trastuzumab (Herceptin®) therapy (anthracycline-containing regimens are permitted). Patients receiving Herceptin® with their chemotherapy are permitted for eligibility work-up. Taxanes are permitted. Trastuzumab (Herceptin®) therapy may be given with or after primary chemotherapy. Pertuzumab may be used in conjunction with trastuzumab.
- Left Ventricular Ejection Fraction (LVEF) ≥ 50% by MUGA scan or echocardiogram
- Adequate renal function for administration of trastuzumab-containing chemotherapy regimen.
- Sitting systolic blood pressure of > 90 mm Hg
- Pulse ≥ 60 beats/minute
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- Not pregnant or breastfeeding
- Female patients of childbearing potential, who are sexually active, must have a negative pregnancy test before starting the study
- Both men and women must be willing to use effective contraception during the study. Teratogenicity is documented for both active study agents
- Able to swallow capsules
Who cannot join
- Patients with metastatic disease
- Prior treatment with trastuzumab or anthracyclines prior to this chemotherapy regimen
- Current treatment with angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), such as losartan, β-blockers or digoxin
- Known cardiac history: heart failure, myocardial infarction, radiation-induced cardiac dysfunction
- Known allergy to either ACE inhibitors or β-blockers
- History of bronchial asthma or related bronchospastic conditions
Show all 9Show fewer
- Hereditary or idiopathic angioedema
- History of severe hypersensitivity reactions to drugs or other causes, i.e. bee stings
- This protocol does not exclude patients who are participating on other investigational studies. Refer to the local IRB guidelines.
Trial locations and contacts
174 sites in 1 country.
174 sites in 1 country
United States174 sites
McDowell Cancer Center at Akron General Medical Center
Akron, Ohio, 44307
Summa Center for Cancer Care at Akron City Hospital
Akron, Ohio, 44309-2090
Lovelace Medical Center - Downtown
Albuquerque, New Mexico, 87102
Presbyterian Cancer Treatment Center at Presbyterian Kaseman Hospital
Albuquerque, New Mexico, 87110
University of New Mexico Cancer Center
Albuquerque, New Mexico, 87131-5636
MBCCOP - Medical College of Georgia Cancer Center
Augusta, Georgia, 30912
Aurora Presbyterian Hospital
Aurora, Colorado, 80012
Mercy Medical Center
Baltimore, Maryland, 21202
Alvin and Lois Lapidus Cancer Institute at Sinai Hospital
Baltimore, Maryland, 21215
Battle Creek Health System Cancer Care Center
Battle Creek, Michigan, 49017
Bay Regional Medical Center
Bay City, Michigan, 48708
Keyserling Cancer Center at Beaufort Memorial Hospital
Beaufort, South Carolina, 29902
Suburban Hospital
Bethesda, Maryland, 20814
Mecosta County Medical Center
Big Rapids, Michigan, 49307
CCOP - Montana Cancer Consortium
Billings, Montana, 59101
Hematology-Oncology Centers of the Northern Rockies - Billings
Billings, Montana, 59102
Billings Clinic - Downtown
Billings, Montana, 59107-7000
Illinois CancerCare - Bloomington
Bloomington, Illinois, 61701
Bloomington Hospital Regional Cancer Institute
Bloomington, Indiana, 47403
Central Care Cancer Center
Bolivar, Missouri, 65613
Boulder Community Hospital
Boulder, Colorado, 80301-9019
Bozeman Deaconess Cancer Center
Bozeman, Montana, 59715
Fairview Ridges Hospital
Burnsville, Minnesota, 55337
Illinois CancerCare - Canton
Canton, Illinois, 61520
Aultman Cancer Center at Aultman Hospital
Canton, Ohio, 44710-1799
Southeast Cancer Center
Cape Girardeau, Missouri, 63703
Illinois CancerCare - Carthage
Carthage, Illinois, 62321
Cedar Rapids Oncology Associates
Cedar Rapids, Iowa, 52403
Martha Jefferson Hospital Cancer Care Center
Charlottesville, Virginia, 22901
Saint Luke's Hospital
Chesterfield, Missouri, 63017
Resurrection Medical Center
Chicago, Illinois, 60631
Louis A. Weiss Memorial Hospital
Chicago, Illinois, 60640
Medical Oncology and Hematology Associates - West Des Moines
Clive, Iowa, 50325
Penrose Cancer Center at Penrose Hospital
Colorado Springs, Colorado, 80933
Mercy and Unity Cancer Center at Mercy Hospital
Coon Rapids, Minnesota, 55433
Bassett Healthcare Regional Cancer Program at Mary Imogene Bassett Hospital
Cooperstown, New York, 13326
Geisinger Cancer Institute at Geisinger Health
Danville, Pennsylvania, 17822-0001
David L. Rike Cancer Center at Miami Valley Hospital
Dayton, Ohio, 45409
Samaritan North Cancer Care Center
Dayton, Ohio, 45415
CCOP - Dayton
Dayton, Ohio, 45420
Decatur Memorial Hospital Cancer Care Institute
Decatur, Illinois, 62526
St. Anthony Central Hospital
Denver, Colorado, 80204
Porter Adventist Hospital
Denver, Colorado, 80210
Presbyterian - St. Luke's Medical Center
Denver, Colorado, 80218
St. Joseph Hospital
Denver, Colorado, 80218
Rose Medical Center
Denver, Colorado, 80220
CCOP - Colorado Cancer Research Program
Denver, Colorado, 80222
CCOP - Iowa Oncology Research Association
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at John Stoddard Cancer Center
Des Moines, Iowa, 50309
Medical Oncology and Hematology Associates at Mercy Cancer Center
Des Moines, Iowa, 50314
Barbara Ann Karmanos Cancer Institute
Detroit, Michigan, 48201-1379
Fairview Southdale Hospital
Edina, Minnesota, 55435
Elkhart Clinic, LLC
Elkhart, Indiana, 46514-2098
Michiana Hematology-Oncology, PC - Elkhart
Elkhart, Indiana, 46514
Elkhart General Hospital
Elkhart, Indiana, 46515
Swedish Medical Center
Englewood, Colorado, 80110
Dizzy Gillespie Cancer Institute at Englewood Hospital and Medical Center
Englewood, New Jersey, 07631
Illinois CancerCare - Eureka
Eureka, Illinois, 61530
Blanchard Valley Medical Associates
Findlay, Ohio, 45840
Singh and Arora Hematology Oncology, PC
Flint, Michigan, 48532
Middletown Regional Hospital
Franklin, Ohio, 45005-1066
Mercy and Unity Cancer Center at Unity Hospital
Fridley, Minnesota, 55432
Galesburg Clinic, PC
Galesburg, Illinois, 61401
Charles R. Wood Cancer Center at Glens Falls Hospital
Glens Falls, New York, 12801
Butterworth Hospital at Spectrum Health
Grand Rapids, Michigan, 49503
Lacks Cancer Center at Saint Mary's Health Care
Grand Rapids, Michigan, 49503
Big Sky Oncology
Great Falls, Montana, 59405-5309
Sletten Cancer Institute at Benefis Healthcare
Great Falls, Montana, 59405
North Colorado Medical Center
Greeley, Colorado, 80631
Green Bay Oncology, Limited at St. Vincent Hospital Regional Cancer Center
Green Bay, Wisconsin, 54301-3526
Green Bay Oncology, Limited at St. Mary's Hospital
Green Bay, Wisconsin, 54303
Wayne Hospital
Greenville, Ohio, 45331
St. Francis Hospital
Greenville, South Carolina, 29601
Gibbs Cancer Center - Pelham
Greer, South Carolina, 29651
Illinois CancerCare - Havana
Havana, Illinois, 62644
Geisinger Hazleton Cancer Center
Hazleton, Pennsylvania, 18201
Park Ridge Health
Henderson, North Carolina, 28792
Hutchinson Area Health Care
Hutchinson, Minnesota, 55350
St. Francis Hospital Cancer Care Services
Indianapolis, Indiana, 46237
Mercy Regional Cancer Center
Janesville, Wisconsin, 53547
Goldschmidt Cancer Center
Jefferson City, Missouri, 65109
Freeman Cancer Institute
Joplin, Missouri, 64804
Ella Milbank Foshay Cancer Center at Jupiter Medical Center
Jupiter, Florida, 33458
West Michigan Cancer Center
Kalamazoo, Michigan, 49007-3731
Kalispell Regional Medical Center
Kalispell, Montana, 59901
Good Samaritan Cancer Center at Good Samaritan Hospital
Kearney, Nebraska, 68848-1990
Charles F. Kettering Memorial Hospital
Kettering, Ohio, 45429
Illinois CancerCare - Kewanee Clinic
Kewanee, Illinois, 61443
Howard Community Hospital
Kokomo, Indiana, 46904
Gundersen Lutheran Center for Cancer and Blood
La Crosse, Wisconsin, 54601
La Grange Memorial Hospital
La Grange, Illinois, 60525
Center for Cancer Therapy at LaPorte Hospital and Health Services
La Porte, Indiana, 46350
Lakeland Regional Cancer Center at Lakeland Regional Medical Center
Lakeland, Florida, 33805
Great Lakes Cancer Institute - Lapeer Campus
Lapeer, Michigan, 48446
Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756-0002
Lucille P. Markey Cancer Center at University of Kentucky
Lexington, Kentucky, 40536-0093
Littleton Adventist Hospital
Littleton, Colorado, 80122
Sky Ridge Medical Center
Lone Tree, Colorado, 80124
Todd Cancer Institute at Long Beach Memorial Medical Center
Long Beach, California, 90806
Monmouth Medical Center
Long Branch, New Jersey, 07740-6395
Hope Cancer Care Center at Longmont United Hospital
Longmont, Colorado, 80501
McKee Medical Center
Loveland, Colorado, 80539
Illinois CancerCare - Macomb
Macomb, Illinois, 61455
HealthEast Cancer Care at St. John's Hospital
Maplewood, Minnesota, 55109
CCOP - Mount Sinai Medical Center
Miami Beach, Florida, 33140
Virginia Piper Cancer Institute at Abbott - Northwestern Hospital
Minneapolis, Minnesota, 55407
Hennepin County Medical Center - Minneapolis
Minneapolis, Minnesota, 55415
Michiana Hematology-Oncology, PC - South Bend
Mishawaka, Indiana, 46545-1470
Saint Joseph Regional Medical Center
Mishawaka, Indiana, 46545-1470
Montana Cancer Specialists at Montana Cancer Center
Missoula, Montana, 59807-7877
Illinois CancerCare - Monmouth
Monmouth, Illinois, 61462
Clemens Regional Medical Center
Mount Clemens, Michigan, 48043
Good Samaritan Regional Health Center
Mount Vernon, Illinois, 62864
D.N. Greenwald Center
Mukwonago, Wisconsin, 53149
Mercy General Health Partners
Muskegon, Michigan, 49444
Foundation Medical Partners
Nashua, New Hampshire, 03060
Oncology Center at St. Joseph Hospital
Nashua, New Hampshire, 03060
MBCCOP - LSU Health Sciences Center
New Orleans, Louisiana, 70112
UMDNJ University Hospital
Newark, New Jersey, 07103
Illinois CancerCare - Community Cancer Center
Normal, Illinois, 61761
Cancer Care Associates - Norman
Norman, Oklahoma, 73071
Advocate Christ Medical Center
Oak Lawn, Illinois, 60453-2699
Regional Cancer Center at Oconomowoc Memorial Hospital
Oconomowoc, Wisconsin, 53066
Cancer Care Associates - Mercy Campus
Oklahoma City, Oklahoma, 73120
Oncology Hematology Associates of Central Illinois, PC - Ottawa
Ottawa, Illinois, 61350
Parker Adventist Hospital
Parker, Colorado, 80138
Illinois CancerCare - Pekin
Pekin, Illinois, 61603
CCOP - Illinois Oncology Research Association
Peoria, Illinois, 61615
Illinois CancerCare - Peru
Peru, Illinois, 61354
Northern Michigan Hospital
Petoskey, Michigan, 49770
Joan Karnell Cancer Center at Pennsylvania Hospital
Philadelphia, Pennsylvania, 19107
Cancer Center at Phoenixville Hospital
Phoenixville, Pennsylvania, 19460
Michiana Hematology Oncology PC - Plymouth
Plymouth, Indiana, 46563
Jordan Hospital Club Cancer Center
Plymouth, Massachusetts, 02360
Mercy Hospital
Portland, Maine, 04101
Illinois CancerCare - Princeton
Princeton, Illinois, 61356
St. Mary - Corwin Regional Medical Center
Pueblo, Colorado, 81004
Rapid City Regional Hospital
Rapid City, South Dakota, 57701
Reid Hospital & Health Care Services
Richmond, Indiana, 47374
West Suburban Center for Cancer Care
River Forest, Illinois, 60305
Humphrey Cancer Center at North Memorial Outpatient Center
Robbinsdale, Minnesota, 55422-2900
Lakeland Regional Cancer Care Center - St. Joseph
Saint Joseph, Michigan, 49085
Lakeside Cancer Specialists, PLLC
Saint Joseph, Michigan, 49085
CCOP - Metro-Minnesota
Saint Louis Park, Minnesota, 55416
Park Nicollet Cancer Center
Saint Louis Park, Minnesota, 55416
Regions Hospital Cancer Care Center
Saint Paul, Minnesota, 55101
United Hospital
Saint Paul, Minnesota, 55102
Nancy N. and J. C. Lewis Cancer and Research Pavilion at St. Joseph's/Candler
Savannah, Georgia, 31405
Guthrie Cancer Center at Guthrie Clinic Sayre
Sayre, Pennsylvania, 18840
St. Francis Cancer Center at St. Francis Medical Center
Shakopee, Minnesota, 55379
CCOP - Northern Indiana CR Consortium
South Bend, Indiana, 46601
Memorial Hospital of South Bend
South Bend, Indiana, 46601
Providence Cancer Institute at Providence Hospital - Southfield Campus
Southfield, Michigan, 48075
Regional Cancer Center at Memorial Medical Center
Springfield, Illinois, 62781-0001
Missouri Baptist Cancer Center
St Louis, Missouri, 63131
Mercy Hospital St. Louis
St Louis, Missouri, 63141
Geisinger Medical Group - Scenery Park
State College, Pennsylvania, 16801
Nalitt Cancer Institute at Staten Island University Hospital
Staten Island, New York, 10305
Lakeview Hospital
Stillwater, Minnesota, 55082
Olive View - UCLA Medical Center Foundation
Sylmar, California, 91342
Munson Medical Center
Traverse City, Michigan, 49684
UVMC Cancer Care Center at Upper Valley Medical Center
Troy, Ohio, 45373-1300
Natalie Warren Bryant Cancer Center at St. Francis Hospital
Tulsa, Oklahoma, 74136
Franklin & Edith Scarpa Regional Cancer Center at South Jersey Healthcare
Vineland, New Jersey, 08360
Ridgeview Medical Center
Waconia, Minnesota, 55387
Covenant Cancer Treatment Center
Waterloo, Iowa, 50702
Waukesha Memorial Hospital Regional Cancer Center
Waukesha, Wisconsin, 53188
Michiana Hematology Oncology PC - La Porte
Westville, Indiana, 46391
Exempla Lutheran Medical Center
Wheat Ridge, Colorado, 80033
Frank M. and Dorothea Henry Cancer Center at Geisinger Wyoming Valley Medical Center
Wilkes-Barre, Pennsylvania, 18711
Willmar Cancer Center at Rice Memorial Hospital
Willmar, Minnesota, 56201
Minnesota Oncology - Woodbury
Woodbury, Minnesota, 55125
United States Air Force Medical Center - Wright-Patterson
Wright-Patterson Air Force Base, Ohio, 45433-5529
Ruth G. McMillan Cancer Center at Greene Memorial Hospital
Xenia, Ohio, 45385
About this study
Official title: Phase II Placebo-controlled Trial of Lisinopril and Coreg CR® to Reduce Cardiotoxicity in Patients With Breast Cancer Receiving (Neo)Adjuvant Chemotherapy With Trastuzumab (Herceptin®)
RATIONALE: Lisinopril or Coreg CR®, may help reduce side effects caused by trastuzumab. It is not yet known whether lisinopril or Coreg CR® are more effective than a placebo in reducing side effects caused by trastuzumab.
PURPOSE: This phase II trial is studying lisinopril and Coreg CR® to see how well they work compared with a placebo in reducing side effects in patients with HER2-positive breast cancer receiving trastuzumab.
Read the detailed description
OBJECTIVES:
Primary
- The primary objective of this study is to determine if administration of lisinopril or Coreg CR®, compared to placebo, will reduce the incidence of trastuzumab-induced cardiotoxicity, as measured by LVEF, in patients receiving adjuvant, or neoadjuvant,therapy for HER2 positive breast cancer.
Secondary
- To determine whether subjects randomized to active agent have fewer interruptions in trastuzumab therapy due to cardiomyopathy.
- To determine whether the treatment effect is consistent in anthracycline and nonanthracycline patient cohorts
- To compare changes in HRQL among the treatment groups during the study intervention
- To evaluate the long term effects on the prevention of cardiomyopathy and impact on HRQL for either or both study agents
- To compare the predictive value of troponin I and BNP in the identification of trastuzumab-induced cardiotoxicity
OUTLINE: This is a multicenter study. Patients are stratified according to chemotherapy comprising an anthracycline (yes vs no). Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive oral lisinopril once daily.
- Arm II: Patients receive oral Coreg CR® once daily.
- Arm III: Patients receive oral placebo once daily.
In all arms, study treatment begins with the first dose of trastuzumab and continues for up to 52 weeks or until the end of trastuzumab therapy.
Quality of life is assessed using the EORTC QLQ-C30 questionnaire at baseline, at 52 weeks (or at the end of trastuzumab therapy), and at 18 and 24 months (or 6 and 12 months after the completion of trastuzumab).
After completion of study treatment, patients are followed up at 3, 6, 9, and 12 months.
- Conditions
- Breast Cancer, Cardiac Toxicity
- Being tested
- Coreg CR®, lisinopril, placebo
- Keywords
- cardiac toxicity, HER2-positive breast cancer, recurrent breast cancer, stage IA breast cancer, stage IB breast cancer, stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer, stage IIIC breast cancer, male breast cancer
- Medical subject headings
- Breast Neoplasms, Cardiotoxicity, Breast Neoplasms, Male
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Coreg CR®Drug
Also called carvedilol phosphate extended-release
Given orally
lisinoprilDrug
Also called Registered Trade names: Prinivil, Tensopril, Zestril, Hipril
Given orally
placeboOther
Given orally
| Study group | Role | What they receive |
|---|---|---|
| Arm I lisinopril | Experimental | Patients receive oral lisinopril once daily. Receives: Drug: lisinopril |
| Arm II Coreg CR® | Experimental | Patients receive oral Coreg CR® once daily. Receives: Drug: Coreg CR® |
| Arm III placebo | Placebo comparator | Patients receive oral placebo once daily. Receives: Other: placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Trastuzumab-Induced Cardiotoxicity After 52 Weeks of Treatment
Reduction in incidence of trastuzumab-induced cardiotoxicity after 52 weeks of treatment as measured by preservation of Left Ventricular Ejection Fraction (LVEF). Number of Patients who experienced a cardiotoxicity.
Measured: 2 years
Number of Participants With LVEF Decrease to <50%
Number of Participants with Left Ventricular Ejection Fraction (LVEF) drop to <50%
Measured: 2 years
Secondary outcomes (3)
Number of Patients With Trastuzumab Course Interruption
Measure indicates the number of patients who had an interruption of trastuzumab for any reason
Measured: 2 years
Quality-of-life Changes Between Baseline and 52-weeks
Quality-of-life changes as assessed by North European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30), which measures the quality of life of cancer patients. Higher score indicates higher quality of life. Score range is 0-100. The questionnaire was administered at baseline and at 52 weeks.
Measured: 52 weeks
Number of Participants With Cardiotoxicity-free Survival at 750 Days From Baseline
Number of Participants with cardiotoxicity-free survival at 750 days from baseline
Measured: 2 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Nov 2009 (estimated)
- Study startMar 2010
- Primary completionAug 2017
- Study completionNov 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Breast CancerStudies of the same condition, open and under way.
- More trials run by University of South FloridaThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 468 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of South Florida
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Sponsor
- Investigators
- Maya Guglin, MD, PhD, Study chair, University of South FloridaPamela N. Munster, MD, Study chair, University of California, San Francisco
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01009918
- Sponsor's protocol ID
- SCUSF 0806
- Other IDs
- SCUSF-0806, 5U10CA081920-11
- Status last verified
- Apr 2019
- First submitted
- 6 Nov 2009
- Last updated
- 30 Mar 2021
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Guglin M, Krischer J, Tamura R, Fink A, Bello-Matricaria L, McCaskill-Stevens W, Munster PN. Randomized Trial of Lisinopril Versus Carvedilol to Prevent Trastuzumab Cardiotoxicity in Patients With Breast Cancer. J Am Coll Cardiol. 2019 Jun 11;73(22):2859-2868. doi: 10.1016/j.jacc.2019.03.495.
PubMed 31171092
Study at a glance
From the registry record, last updated by the sponsor on 30 Mar 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Phase II Placebo-controlled Trial of Lisinopril and Coreg CR® to Reduce Cardiotoxicity in Patients With Breast Cancer Receiving (Neo)Adjuvant Chemotherapy With Trastuzumab (Herceptin®)
- ClinicalTrials.gov ID
- NCT01009918
- Acronym / sponsor ID
- SCUSF 0806
- Conditions
- Breast Cancer, Cardiac Toxicity
- Keywords
- cardiac toxicity, HER2-positive breast cancer, recurrent breast cancer, stage IA breast cancer, stage IB breast cancer, stage II breast cancer, stage IIIA breast cancer, stage IIIB breast cancer
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 468 participants (actual)
- Lead sponsor
- University of South FloridaUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Mar 2010
- Primary completion
- Aug 2017 (actual)
- Study completion
- Nov 2018 (actual)
- First posted
- 9 Nov 2009 (estimated)
- Results
- Posted 30 Mar 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
RATIONALE: Lisinopril or Coreg CR®, may help reduce side effects caused by trastuzumab. It is not yet known whether lisinopril or Coreg CR® are more effective than a placebo in reducing side effects caused by trastuzumab.
PURPOSE: This phase II trial is studying lisinopril and Coreg CR® to see how well they work compared with a placebo in reducing side effects in patients with HER2-positive breast cancer receiving trastuzumab.
Detailed description
OBJECTIVES:
Primary
- The primary objective of this study is to determine if administration of lisinopril or Coreg CR®, compared to placebo, will reduce the incidence of trastuzumab-induced cardiotoxicity, as measured by LVEF, in patients receiving adjuvant, or neoadjuvant,therapy for HER2 positive breast cancer.
Secondary
- To determine whether subjects randomized to active agent have fewer interruptions in trastuzumab therapy due to cardiomyopathy.
- To determine whether the treatment effect is consistent in anthracycline and nonanthracycline patient cohorts
- To compare changes in HRQL among the treatment groups during the study intervention
- To evaluate the long term effects on the prevention of cardiomyopathy and impact on HRQL for either or both study agents
- To compare the predictive value of troponin I and BNP in the identification of trastuzumab-induced cardiotoxicity
OUTLINE: This is a multicenter study. Patients are stratified according to chemotherapy comprising an anthracycline (yes vs no). Patients are randomized to 1 of 3 treatment arms.
- Arm I: Patients receive oral lisinopril once daily.
- Arm II: Patients receive oral Coreg CR® once daily.
- Arm III: Patients receive oral placebo once daily.
In all arms, study treatment begins with the first dose of trastuzumab and continues for up to 52 weeks or until the end of trastuzumab therapy.
Quality of life is assessed using the EORTC QLQ-C30 questionnaire at baseline, at 52 weeks (or at the end of trastuzumab therapy), and at 18 and 24 months (or 6 and 12 months after the completion of trastuzumab).
After completion of study treatment, patients are followed up at 3, 6, 9, and 12 months.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Arm I lisinopril | Experimental | Drug: lisinoprilPatients receive oral lisinopril once daily. |
| Arm II Coreg CR® | Experimental | Drug: Coreg CR®Patients receive oral Coreg CR® once daily. |
| Arm III placebo | Placebo comparator | Other: placeboPatients receive oral placebo once daily. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (10 listed)
- Males and Females ≥ 18 years old diagnosed with HER2 positive breast cancer
- Scheduled to receive neoadjuvant or adjuvant trastuzumab (Herceptin®) therapy (anthracycline-containing regimens are permitted). Patients receiving Herceptin® with their chemotherapy are permitted for eligibility work-up. Taxanes are permitted. Trastuzumab (Herceptin®) therapy may be given with or after primary chemotherapy. Pertuzumab may be used in conjunction with trastuzumab.
- Left Ventricular Ejection Fraction (LVEF) ≥ 50% by MUGA scan or echocardiogram
- Adequate renal function for administration of trastuzumab-containing chemotherapy regimen.
- Sitting systolic blood pressure of > 90 mm Hg
Key exclusion criteria (9 listed)
- Patients with metastatic disease
- Prior treatment with trastuzumab or anthracyclines prior to this chemotherapy regimen
- Current treatment with angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), such as losartan, β-blockers or digoxin
- Known cardiac history: heart failure, myocardial infarction, radiation-induced cardiac dysfunction
- Known allergy to either ACE inhibitors or β-blockers
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Coreg CR®Also: carvedilol phosphate extended-releaseGiven orally | Drug | Arm II Coreg CR® |
| lisinoprilAlso: Registered Trade names: Prinivil, Tensopril, Zestril, HiprilGiven orally | Drug | Arm I lisinopril |
| placeboGiven orally | Other | Arm III placebo |
Primary outcome
Number of Participants With Trastuzumab-Induced Cardiotoxicity After 52 Weeks of Treatment
Time frame: 2 years
Reduction in incidence of trastuzumab-induced cardiotoxicity after 52 weeks of treatment as measured by preservation of Left Ventricular Ejection Fraction (LVEF). Number of Patients who experienced a cardiotoxicity.
Number of Participants With LVEF Decrease to <50%
Time frame: 2 years
Number of Participants with Left Ventricular Ejection Fraction (LVEF) drop to <50%
3 secondary outcomes
Number of Patients With Trastuzumab Course Interruption
Time frame: 2 years
Quality-of-life Changes Between Baseline and 52-weeks
Time frame: 52 weeks
Number of Participants With Cardiotoxicity-free Survival at 750 Days From Baseline
Time frame: 2 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Mar 2021.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 31171092Guglin M, Krischer J, Tamura R, Fink A, Bello-Matricaria L, McCaskill-Stevens W, Munster PN. Randomized Trial of Lisinopril Versus Carvedilol to Prevent Trastuzumab Cardiotoxicity in Patients With Breast Cancer. J Am Coll Cardiol. 2019 Jun 11;73(22):2859-2868. doi: 10.1016/j.jacc.2019.03.495.
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Lymphedema, Upper Extremity Lymphedema
RecruitingPhase 3
A Study of Camrelizumab Plus Chemotherapy in Combination With or Without Famitinib as Neoadjuvant Therapy in Participants With Triple Negative Breast Cancer (BCTOP-T-N01)
TNBC - Triple-Negative Breast Cancer
RecruitingPhase 3
Testing Whether Hormone Therapy With Ribociclib is as Effective as Chemotherapy Followed by Hormone Therapy With Ribociclib for the Treatment of High Anatomic Stage Breast Cancer With Low Recurrence Risk, The RxFINE-Low Trial
Anatomic Stage II Breast Cancer AJCC v8, Anatomic Stage IIIA Breast Cancer AJCC v8
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Maya Guglin, MD, PhD study chair
University of South Florida
Pamela N. Munster, MD study chair
University of California, San Francisco
174 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Coreg CR® and lisinopril in people with Breast Cancer and Cardiac Toxicity, run by University of South Florida at 174 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 30 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 174 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 30 Mar 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Trastuzumab-Induced Cardiotoxicity After 52 Weeks of Treatment (time frame: 2 years). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01009918, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Mar 2021.