Early Detection of Cardiac Toxicity in Childhood Cancer Survivors

Study Overview
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Brief Summary
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To evaluate cardiac MRI and/or serum biomarkers for detecting cardiac cardiac toxicity in children who received anthracycline based chemotherapy (ABC).

Detailed Description
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Cardiac toxicity is a significant potential complication for patients receiving anthracycline chemotherapy. Cells in the cardiovascular system have limited regenerative capability, making them susceptible to long term adverse effects from these chemotherapeutic agents. The ability to detect subclinical changes in cardiac function will allow clinicians to use proven treatments to prevent further progression in this vulnerable population. The current standard testing uses echocardiography, which is not as sensitive as cardiac MRI or serum biomarkers.

Official Title
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Early Detection of Cardiac Toxicity in Childhood Cancer Survivors

Conditions
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Heart Failure, Cardiotoxicity

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Subjects that have received anthracycline based chemotherapy Age: 8 years old - 25 years old Subjects that do not require sedation for cardiac MRI. Subjects must have completed treatment in the last 10 years Exclusion Criteria: Patients with significant congenital heart defects Patients with renal injury or renal failure, defined as an estimated glomerular filtration rate [eGFR] <30 ml/min/1.73 m2 body surface area), as previously calculated) Patients that require sedation for a cardiac MRI Subjects that are pregnant or lactating Patients with contraindications to a cardiac MRI: Cardiac pacemaker or implantable defibrillator Cerebral aneurysm clip Neural stimulator Metallic ocular foreign body Any implanted device (i.e. insulin pump, drug infusion device) Claustrophobia Metal shrapnel or bullet Investigator assessment of inability to comply with protocol Unable/unwilling to lie still throughout the research procedure Persons with cognitive impairment

Ages Eligible for Study
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Minimum Age: 8 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Echocardiogram marker measurements pre ABC chemo and post ABC | •Measure echocardiogram markers on pre anthracycline based chemotherapy (ABC) and post ABC echocardiograms, using standard echocardiogram measurements and speckle tracking. | At the end of each cardiac MRI exam through study completion, up to 5 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Detection of cardiac toxicity on MRI and echocardiogram | •Measure sensitivity of detecting cardiac toxicity between standard echocardiogram, speckle tracking on echo, and MRI | At the end of each cardiac MRI exam through study completion, up to 5 years | 
| Serum biomarkers correlation | •Correlate measurement of serum biomarkers with prevalence of cardiac changes measured on echocardiograms and MRI imaging. | At the end of the study, up to 10 years |